Pyloroplasty for Refractory Diabetic Gastroparesis After Renal Transplantation

Gastroparesis (GP) is a symptomatic delay in gastric emptying in the absence of mechanical obstruction. Symptoms can be subjectively reported by the validated Gastroparesis Cardinal Symptom Index (GCSI). Gastroparesis is common in patients with diabetes. Although GP can improve after transplantation, many cases remain severe and refractory to medical therapy. These refractory cases may be associated with recurrent hospitalizations and difficulty in complying with posttransplant medication regimens. Pyloric dysfunction plays a role in GP. This case report features 2 patients with type I diabetes status after renal transplantation who underwent pyloroplasty for refractory GP. Both patients demonstrated subsequent reduction in symptoms, acceleration of gastric emptying scintigraphy (GES), and decreased hospitalizations.