Delayed Cardiac Tamponade and Hemothorax Induced by an Acupuncture Needle

Hasegawa, Junichi; Noguchi, Noriyasu; Yamasaki, Junichi; Kotake, Hiroshi; Mashiba, Hiroto; Sasaki, Shunsaku; Mori, Tohru

doi:10.1159/000174766

Cited by 49 publications

(20 citation statements)

References 10 publications

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“…According to Peuker et al,7 cases of injuries to the heart and the pericardium have been described in scientific literature (Ye;Schiff;Nieda et al, 1973;Cheng, 1991;Hasegawa et al;Halvorsen et al;Kataoka), among which 3 were fatal (Ye; Schiff; Halvorsen et al), two of the fatal cases were caused by lack of awareness of the sternal foramen.…”

Section: Discussionmentioning

confidence: 99%

“…The sternal foramen is an anatomical variation that has been well described in the aspects: morphological (McCormick, 1981;McCormick & Nichols, 1981;Bergman et al, 1988;Cooper et al, 1988;Williams et al, 1996), in clinical acupuncture (Fokin, 2000;Hecker et al, 2005), the risk of inadvertent use of acupuncture point on the foramen (Bichel, 1989;Chen, 1995;Ernst, 1995;Peuker et al, 1999) and complications of puncture through the foramen (Hasegawa et al, 1991;Halvorsen et al, 1995;Wolochow, 1995;Kataoka, 1997;Kirchgatterer et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

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High Prevalence of Sternal Foramen: Quantitative, Anatomical Analysis and its Clinical Implications in Acupuncture Practice

et al. 2012

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SUMMARY:The aim of our study was to verify the prevalence of the sternal foramen in adult cadavers and dry bones, as well as to determine its exact localization and relation to acupuncture points. One hundred eighty sternums fixed and contained in 10% formaldehyde solution were examined, of which 100 were dry bones and 80 belonged to adult cadavers. The morphometric measures were expressed in millimeters when measuring the length: 1) from jugular incision to the foramen (JI-F); 2) from sternal angle to the foramen (EA-F); 3) from xiphoid process to the foramen (XP-F). Statistical analysis was performed to compare expected vs obtained foramina frequency, using Fisher's test (p≤0.05 was considered significant). The results showed 16.6% sternal foramina, significant higher than expected (p≤0.0248). Of the 30 foramina, 53.3% were found in cadavers, of which one was a woman, and 46.7% sternums were found in dry bones. Of the cadavers with sternal foramen, 10 foramina were at the 5th sternochondral articulation level and 6 foramina at the 4th sternochondral level. Of the 14 analyzed dry bones, 9 foramina were at the space between the 4th and the 5th costal pit level and 5 foramina were at the 5th costal pit level. The mean±SD (mm) total length of the sternums was 151.8±34 and the measures JI-F, EA-F, and XP-F were, respectively, 103.8±22.1mm, 65.6±15mm and 46.9 ±15mm. Knowledge of this occurrence is important to avoid serious heart injury by needle insertion, especially as this area holds a commonly used acupuncture point and sternal puncture.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High Prevalence of Sternal Foramen: Quantitative, Anatomical Analysis and its Clinical Implications in Acupuncture Practice

et al. 2012

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“…To our knowledge, six cases of injuries to the heart and the pericardium have been described in the scientific literature so far; [6][7][8][9][10][11] we were notified of two more cases during the last year by colleagues from France and Canada. Two of the reported cases ended fatally.…”

Section: Thoracic Viscera Cardiac Tamponadementioning

confidence: 99%

Rare but Serious Complications of Acupuncture: Traumatic Lesions

Peuker

Grönemeyer

2001

Acupunct Med

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Acupuncture has a reputation among the public of being safe. Although recently performed prospective studies on the frequency of adverse effects of acupuncture found no severe complication, since 1965 many case reports of serious or even life-threatening incidents caused by acupuncture have appeared in the scientific literature. The most frequently reported complications are pneumothorax and lesions of the spinal cord. Severe injuries of peripheral nerves and blood vessels due to acupuncture seem to be very rare. Although case reports do not produce reliable data on the frequency of adverse events, information on sources of application errors can be extracted to increase the quality of acupuncture in education and therapy. All traumatic injuries described in this article could be avoided if practitioners had better anatomical knowledge, applied existing anatomical knowledge better, or both.

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“…Several risk factors have been considered damage to the heart and great vessels through the foramina has occurred in transthoracic and abdominal penetration; seven cases of injuries to the heart and the pericardium have been described in scientific literature. [11][12][13][14] Among which three were fatal, two of the fatal cases were caused by lack of awareness of the sternal foramen. 15,16 Knowledge of the existence of such anatomical variants is important to the clinician because infiltration, biopsy or acupuncture of this area may lead to fatal cardiac complications.…”

Section: Discussionmentioning

confidence: 99%

Anatomical and congenital variations of human dry sternum bone: its embryogenesis and clinical implications

Chakravarthi¹,

Nelluri

et al. 2017

Int J Res Med Sci

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Background: The sternum is one of the skeleton parts with frequently detected variation in cross-sectional images or autopsy series. The anatomical or congenital variations of the sternum in the anterior chest wall may involve malignancies, injuries or severe traumas. The aim of the study was undertaken to evaluate the incidence of anatomical and congenital variations of human dry sternum bones.Methods: This study was carried out on 120 dry human sternum bones irrespective of age and sex at Varun Arjun medical college- Banthra, UP, KMCT Medical College, Manassery-Calicut and Melaka Manipal Medical College-Manipal. All the sternum bones were macroscopically inspected for the anatomical and congenital variations of human dry sternum bones. Photographs of the anatomical and congenital variations were taken for proper documentation.Results: Complete sternal foramina in the body of the sternum were noted in 9 bones (7.5%), with an average vertical diameter of 17mm and transverse diameter of 16mm (The highest vertical diameter of 19mm and transverse diameter of 17mm was noted); Incomplete sternal foramina in the body of the sternum were noted in 4 bones (3.3%);Complete sternal foramina in the xiphoid process of the sternum were noted in 7 bones (5.8%) with an average vertical diameter of 6mm and transverse diameter of 8mm; Unusual complete sternal foramina in the body and incomplete sternal foramina in the xiphoid process of the sternum were noted in 8 bones (6.6%); Very rare longer xiphoid process (7.3 cm) with complete sternal foramina was noted in 7 bone (5.8%); Unusual Longer xiphoid process with an average length of 6.7cm with sharp bifid ends was noted in 8 bones (6.6%).Conclusions: The knowledge of existence of anatomical variants and congenital foramina of sternum and xiphoid process found in our study is essential, especially for bone marrow sampling, radiology (X - ray, CT, MRI, and USG) reporting, pathology autopsy and forensic medicine post-mortem reporting and patoacupuncture practice to avoid complications during various surgical procedures.

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Delayed Cardiac Tamponade and Hemothorax Induced by an Acupuncture Needle

Cited by 49 publications

References 10 publications

High Prevalence of Sternal Foramen: Quantitative, Anatomical Analysis and its Clinical Implications in Acupuncture Practice

High Prevalence of Sternal Foramen: Quantitative, Anatomical Analysis and its Clinical Implications in Acupuncture Practice

Rare but Serious Complications of Acupuncture: Traumatic Lesions

Anatomical and congenital variations of human dry sternum bone: its embryogenesis and clinical implications

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