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Migration of Broken Sewing Needle from Left Arm to Heart

1975; Elsevier BV; Volume: 67; Issue: 5 Linguagem: Inglês

10.1378/chest.67.5.626

1931-3543

Jui-chang Yu, Kwok‐Kei Cheng,

Traumatic Ocular and Foreign Body Injuries

To the Editor:Intracardiac foreign bodies have been reported to be not uncommon in wartime. Most of the foreign bodies retained in the heart are due to direct penetrating trauma.1Decker HR Foreign bodies in the heart and pericardium: Should they be removed?.J Thorac Cardiovasc Surg. 1963; 9: 62Google Scholar, 2Harken DE Zoll PM Indications for removal of intracardiac bodies.Am Heart J. 1946; 32: 1Abstract Full Text PDF PubMed Scopus (33) Google Scholar, 3Harken DE Williams AC Migratory foreign bodies within the vascular system.Am J Surg. 1946; 72: 80Abstract Full Text PDF PubMed Scopus (33) Google Scholar, 4Holdefer WF Lyons C Edwards WS Indication for removal of intracardiac bodies: Review and report of four cases.Ann Surg. 1966; 163: 249Crossref PubMed Scopus (12) Google Scholar Those migrating from peripheral circulation to the heart are rare.1Decker HR Foreign bodies in the heart and pericardium: Should they be removed?.J Thorac Cardiovasc Surg. 1963; 9: 62Google Scholar, 5Samoan AA Intracardiac foreign bodies.Br J Surg. 1970; 57: 685Crossref PubMed Scopus (3) Google Scholar However, the increasing use of intravenous polyethylene catheters has led to a growing incidence of accidental catheter breakage and migration of fragments to the heart. Here a very unusual case is reported: a migratory broken sewing needle traveled from a man's left arm to his heart and was successfully removed by open heart surgery.The patient was a 24-year-old single male laborer. About 11 days prior to his admission to Taiwan Veterans General Hospital, the inner aspect of his left upper arm was accidentally penetrated by a household sewing needle. The extending part (about one third) of the needle was fractured, making withdrawal of the remainder impossible. Immediate x-ray examination at a private clinic disclosed the needle fragment to have been retained in the left upper arm. He suffered no discomfort until five days after injury, when he suddenly sustained a sharp chest pain of brief duration. Chest films were taken and disclosed the presence of the broken needle in his heart (Fig 1). Followup chest films at TVGH showed no definite change in the position of the broken needle. Open heart surgery with the aid of extracorporeal perfusion, was carried out on October 12, 1973, four days after admission. The right ventricular cavity was entered through a small longitudinal right ventriculotomy. The needle fragment was found embedded in the interventricular septum near the apex. Only a small part of the needle (about 0.4 cm), ringed by a band of thrombus, could be viewed from the right ventricle. The remaining part had probably penetrated the interventricular septum towards the left ventricle. The needle, measuring 2 cm long and noted to be rusty, was carefully removed.The patient stood the operative procedure well and had an uneventful postoperative course. To the Editor: Intracardiac foreign bodies have been reported to be not uncommon in wartime. Most of the foreign bodies retained in the heart are due to direct penetrating trauma.1Decker HR Foreign bodies in the heart and pericardium: Should they be removed?.J Thorac Cardiovasc Surg. 1963; 9: 62Google Scholar, 2Harken DE Zoll PM Indications for removal of intracardiac bodies.Am Heart J. 1946; 32: 1Abstract Full Text PDF PubMed Scopus (33) Google Scholar, 3Harken DE Williams AC Migratory foreign bodies within the vascular system.Am J Surg. 1946; 72: 80Abstract Full Text PDF PubMed Scopus (33) Google Scholar, 4Holdefer WF Lyons C Edwards WS Indication for removal of intracardiac bodies: Review and report of four cases.Ann Surg. 1966; 163: 249Crossref PubMed Scopus (12) Google Scholar Those migrating from peripheral circulation to the heart are rare.1Decker HR Foreign bodies in the heart and pericardium: Should they be removed?.J Thorac Cardiovasc Surg. 1963; 9: 62Google Scholar, 5Samoan AA Intracardiac foreign bodies.Br J Surg. 1970; 57: 685Crossref PubMed Scopus (3) Google Scholar However, the increasing use of intravenous polyethylene catheters has led to a growing incidence of accidental catheter breakage and migration of fragments to the heart. Here a very unusual case is reported: a migratory broken sewing needle traveled from a man's left arm to his heart and was successfully removed by open heart surgery. The patient was a 24-year-old single male laborer. About 11 days prior to his admission to Taiwan Veterans General Hospital, the inner aspect of his left upper arm was accidentally penetrated by a household sewing needle. The extending part (about one third) of the needle was fractured, making withdrawal of the remainder impossible. Immediate x-ray examination at a private clinic disclosed the needle fragment to have been retained in the left upper arm. He suffered no discomfort until five days after injury, when he suddenly sustained a sharp chest pain of brief duration. Chest films were taken and disclosed the presence of the broken needle in his heart (Fig 1). Followup chest films at TVGH showed no definite change in the position of the broken needle. Open heart surgery with the aid of extracorporeal perfusion, was carried out on October 12, 1973, four days after admission. The right ventricular cavity was entered through a small longitudinal right ventriculotomy. The needle fragment was found embedded in the interventricular septum near the apex. Only a small part of the needle (about 0.4 cm), ringed by a band of thrombus, could be viewed from the right ventricle. The remaining part had probably penetrated the interventricular septum towards the left ventricle. The needle, measuring 2 cm long and noted to be rusty, was carefully removed. The patient stood the operative procedure well and had an uneventful postoperative course.