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Transcolonic Migration of Retained Epicardial Pacing Wires.

Gonzales S, White H, Echavarria J - Case Rep Radiol (2015)

Bottom Line: Most of these occur in the chest.Even rarer are complications that occur within the abdomen.We report a case of migrating epicardial pacing wires entering the abdomen and penetrating the transverse colon found incidentally on colonoscopy in an asymptomatic patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.

ABSTRACT
Temporary epicardial pacing wires are associated with rare complications. Most of these occur in the chest. Even rarer are complications that occur within the abdomen. We report a case of migrating epicardial pacing wires entering the abdomen and penetrating the transverse colon found incidentally on colonoscopy in an asymptomatic patient.

No MeSH data available.


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Mentions: A 62-year-old male with a past medical history of heart disease status after coronary artery bypass grafting (CABG) in August 2010 and implantable cardioverter defibrillator placement in April 2014 presented for a routine screening colonoscopy in December 2014. During screening colonoscopy, two yellow wires were seen within the lumen of the colon (Figures 1–3). Per colonoscopy report, “one end of both wires was moving loosely in the lumen, whereas the other end of both wires seems to be protruding externally into the colon through the mucosa” (Figure 4). Once the wires were identified within the colon, the colonoscopy was aborted. The patient was asymptomatic at the time, and CT abdomen/pelvis was ordered for further evaluation. CT demonstrated two migrating epicardial pacing wires (one in the substernal space and one along the right heart border) joining together before passing through the sternocostal triangle, entering the abdomen, and penetrating the transverse colon wall (Figures 5–7). An additional linear metallic fragment within the transverse colon was thought to represent a disconnected migrating segment of an epicardial pacing wire (Figure 8). No associated focal fluid collection, free air, or inflammatory changes were identified. The physician who performed the CABG four years earlier was contacted, who reported that after unsuccessful attempts at removing the wires, the wires were cut at the skin surface. As this is a rare situation without clear guidelines for treatment, the patient was referred for a cardiothoracic surgery consultation. As the patient was asymptomatic, surgical intervention was not pursued.


Transcolonic Migration of Retained Epicardial Pacing Wires.

Gonzales S, White H, Echavarria J - Case Rep Radiol (2015)

© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4488573&req=5

Mentions: A 62-year-old male with a past medical history of heart disease status after coronary artery bypass grafting (CABG) in August 2010 and implantable cardioverter defibrillator placement in April 2014 presented for a routine screening colonoscopy in December 2014. During screening colonoscopy, two yellow wires were seen within the lumen of the colon (Figures 1–3). Per colonoscopy report, “one end of both wires was moving loosely in the lumen, whereas the other end of both wires seems to be protruding externally into the colon through the mucosa” (Figure 4). Once the wires were identified within the colon, the colonoscopy was aborted. The patient was asymptomatic at the time, and CT abdomen/pelvis was ordered for further evaluation. CT demonstrated two migrating epicardial pacing wires (one in the substernal space and one along the right heart border) joining together before passing through the sternocostal triangle, entering the abdomen, and penetrating the transverse colon wall (Figures 5–7). An additional linear metallic fragment within the transverse colon was thought to represent a disconnected migrating segment of an epicardial pacing wire (Figure 8). No associated focal fluid collection, free air, or inflammatory changes were identified. The physician who performed the CABG four years earlier was contacted, who reported that after unsuccessful attempts at removing the wires, the wires were cut at the skin surface. As this is a rare situation without clear guidelines for treatment, the patient was referred for a cardiothoracic surgery consultation. As the patient was asymptomatic, surgical intervention was not pursued.

Bottom Line: Most of these occur in the chest.Even rarer are complications that occur within the abdomen.We report a case of migrating epicardial pacing wires entering the abdomen and penetrating the transverse colon found incidentally on colonoscopy in an asymptomatic patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.

ABSTRACT
Temporary epicardial pacing wires are associated with rare complications. Most of these occur in the chest. Even rarer are complications that occur within the abdomen. We report a case of migrating epicardial pacing wires entering the abdomen and penetrating the transverse colon found incidentally on colonoscopy in an asymptomatic patient.

No MeSH data available.