Laparoscopic extraction of a migrated pacemaker in a 6-year-old child: A case report

Alawami, Murtadha H.; Alzayer, Eman A.; Alqattan, Hussain M.; Alassiri, Ali H.; Jefri, Ahmad Al; Abdullah, Ibrahim

doi:10.1016/j.xjtc.2022.09.019

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…In one case, a 6-year-old boy with a permanent pacemaker placed within the posterior rectus sheath for management of complete heart block presented with mild intermittent, nonspeci c lower abdominal pain and fever. 3 His abdominal exam was benign, but a radiograph and ultrasound showed the device located in the pelvic cavity without evidence of visceral injury; the device was removed laparoscopically. A 2-year-old girl with the same diagnosis suffered from intermittent abdominal pain and presented to care once her family noticed prolapse of the device via the rectum.…”

Section: Discussionmentioning

confidence: 99%

Wandering Pacemaker: A Case Report

Perez-Kersey,

Gallotti,

Permut

et al. 2024

Preprint

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Background Pacemaker implantation in children is nuanced. While indications for permanent pacing are similar to those in adults, the logistics of implanting large generators in small infants and children introduces many potential complications, perhaps most insidious migration. In small children, pacemaker leads are placed on the epicardium via sternotomy and the generator is placed anterior or posterior to the rectus abdominis sheath. This precarious position is prone to erosion. Case Presentation Our patient is an 8-year-old female with an underlying glycosylation disorder with multi-organ involvement and global developmental delay. She underwent permanent pacemaker placement at 2 years of age due to prolonged sinus pauses of unclear etiology. She presented to care several times for non-specific illness symptoms, with the pacemaker ultimately being found to have migrated into the gastrointestinal tract. The device was safely extracted via the rectum by general surgery. Conclusions We present a case of pacemaker migration into the gastrointestinal tract, review the literature on this infrequent but significant complication, and provide recommendations to aid in the prompt recognition of this predicament. This case highlights that routine assessment of a pacemaker’s position and function is critical to ensuring patient safety.

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Section: Discussionmentioning

confidence: 99%