An unusual cause of dyspepsia due to a retained epicardial pacing wire

Temporary epicardial pacing wires (TEPWs) are frequently inserted in cardiac surgery procedures. Although overall morbidity related to TEPWs is low, complications related to the insertion, utilization, retrieval, and migration of these wires have been reported in the literature (1). In this report, we describe an unusual case of gastric migration of a TEPW, which eventually caused dyspeptic symptoms. A 74-year-old man was admitted to our gastroenterology clinic for evaluation of worsening dyspeptic symptoms. Over the previous four months, he had suffered from continuous epigastric burning and pain. The patient had undergone coronary bypass grafting one year prior to the admission. On upper gastrointestinal endoscopy, a blue wire was identified that had penetrated the distal anterior wall of the gastric corpus (Figure 1). Retrieval of the foreign body was attempted but failed and the endoscopic procedure was terminated. For further evaluation, thoracic and abdominal computed tomography scans were performed. With imaging, the location and path of the wire were confirmed, from the right ventricle, passing through the sternocostal triangle, entering the abdomen, and penetrating the gastric wall (Figure 2). Consultation with cardiovascular surgery confirmed this wire to be a TEPW, which was cut at the surface of the skin after the bypass procedure.