Foreign bodies in the cardiovascular system

Barrett, N. R.

doi:10.1002/bjs.18003714804

Cited by 98 publications

(31 citation statements)

References 56 publications

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“…Such an occurrence was reported by Shapiro (1941) and by Barrett (1950), with the needle coming to lie, in Shapiro's case, in the pericardial fat between the heart and the diaphragm; (2) the insertion of the object into soft tissues distant from the heart and subsequent slow migration through the tissues to the heart; (3) direct introduction of a pointed object through the chest wall into the heart; (4) by penetration of a needle, impacted in the lower end of the oesophagus, into the right ventricle. Goldberger and Clark (1935) described an unusual case in which a needle accidentally penetrated the chest wall of a man during sleep.…”

Section: Discussionsupporting

confidence: 67%

Foreign body in the myocardium as a cause of constrictive pericarditis

Kishon¹,

Pauzner²,

Dalith³

et al. 1967

Thorax

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An unusual case of constrictive pericarditis, caused by lodging of a needle in the heart wall, is presented and discussed. Attention is focused on the rapid development of the constriction and the benefit gained from surgical intervention.Constrictive pericarditis due to foreign bodies is exceedingly rare. During the past three decades the relationship between trauma and constrictive pericarditis has been established in welldocumented cases (Warburg, 1933;Glenn, 1940;Straus, 1944;Watts and Toone, 1945;Mortensen and Warburg, 1948;McKusick, 1952).The injurious agents are many, including needles (Straus, 1944) and knives (McKusick, 1952). The relationship between trauma and the development of constrictive pericarditis has been questioned by Robertson and Arnold (1962), and McKusick (1952) states that trauma should not be overlooked in the aetiology, although in his view this cause has never been proven unequivocally.It is the purpose of this paper to describe another case of this condition. Of special interest is the fact that constrictive pericarditis developed very rapidly in this patient, a point which raises the question of the need for prompt surgical intervention in similar cases. CASE REPORTA 32-year-old woman was admitted to the TelHashomer Hospital in August 1953 because of congestive heart failure. One month earlier, while under treatment in a mental hospital, the patient attempted suicide by inserting needles into her chest. Within less than a week she developed fever and transient arrhythmias. She had several episodes of peripheral shock.Physical examination in our hospital revealed an undernourished woman in no acute distress. Her body temperature was 38°C.. the blood pressure was 120/ 100 mm. Hg, and the heart was in sinus rhythm at a rate of 130 per minute. The cardiac impulse was hardly palpable. On percussion there was an increased area of cardiac dullness. The heart sounds were distant but clear. A pleuropericardial friction rub was heard over the lower end of the sternum. There was dullness at the base of the right lung with diminished breath sounds. Moist rales were heard over the left base. The liver was palpable three fingerbreadths below the costal margin and was tender. Paradoxical pulse, Broadbent's sign, and systolic retractions at the apex were absent.FIG. 1. Chest radiograph showing the presence of three needles, two of which are seen to be embedded between the chest wall and the heart, while the third is thought to be embedded within the myocardium. 238 on 9 May 2018 by guest. Protected by copyright.

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Section: Discussionsupporting

confidence: 67%

Foreign body in the myocardium as a cause of constrictive pericarditis

Kishon¹,

Pauzner²,

Dalith³

et al. 1967

Thorax

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“…Therefore, they recommended surgical removal of the bullet. Barrett et al [1] also suggested that removing the bullet might prevent complications resulting from vascular embolism.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous migration of bullet from arm to forearm and its ultrasound guided removal

et al. 2013

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Spontaneous migration of a retained bullet is rare. We are presenting here a case of a 24-year-old male with spontaneous migration of bullet from arm to forearm. At the time of initial injury, bullet was left inside the arm as it was deep and patient had no complaints. Three months after injury, he started complaining of pain over forearm and tingling sensations in the forearm and hand over median nerve distribution. Radiographs showed bullet in the proximal forearm. The bullet was than precisely localized and removed under ultrasound guidance. This case report emphasizes the fact that spontaneous migration of bullet in extremities may occur and have the potential to cause neurovascular damage. Removal under ultrasound guidance is a viable option in such locations.Keywords Arm Á Bullet Á Spontaneous migration Sommario La migrazione spontanea di un proiettile trattenuto è rara. Presentiamo il caso di un paziente maschio, di 24 anni di età, con migrazione spontanea di una pallottola dal braccio all'avambraccio. Al momento iniziale, il proiettile era stato lasciato all'interno del braccio perchè in sede profonda in paziente con scarsa resistenza al dolore. Tre mesi dopo, questi ha iniziato a lamentare dolore al l'avambraccio e sensazioni di formicolio a braccio e mano, nelle aree innervate del nervo mediano. Le radiografie hanno mostrato il proiettile nell'avambraccio prossimale. Il proiettile veniva localizzato con più precisione e rimosso sotto guida ecografica. Questo caso sottolinea il fatto che la migrazione spontanea di un proiettile nelle estremità può verificarsi ed è potenzialmente causa di danni neurovascolari. In tale situazione la rimozione sotto guida ecografica è una valida opzione.

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“…Our patient was discharged from the hospital with other needles (at least 3 needles visible on chest and abdominal roentgenograms) retained in his body. As described in previous reports [2,3,19], elec tive attempts at surgical removal may not be indicated. Although there are some differ ences in indications for surgical removal be tween intracardiac and other superficial for eign bodies, we have not removed the other needles in our patient due to the difficulty in locating them by roentgenography or other forms of examination, and also because of their uneventful course.…”

Section: Discussionmentioning

confidence: 99%

Delayed Cardiac Tamponade and Hemothorax Induced by an Acupuncture Needle

Hasegawa¹,

Noguchi²,

Yamasaki³

et al. 1991

Cardiology

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We report a 52-year-old man who presented with cardiac tamponade a few years after accidental breakage of an acupuncture needle that had not been removed. Thoracotomy showed a hemopericardium with penetration of the pulmonary artery by the very fine needle which was barely detected on the chest roentgenogram. This lesion was not suspected on the basis of roentgenography, two-dimensional echocardiography, or computed tomography, but was detected by the presence of other thick needles in the neck, chest and abdomen. This case showed a possible threat of ‘stealthy’ and migrating foreign bodies, such as very ñne acupuncture needles.

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Foreign bodies in the cardiovascular system

Cited by 98 publications

References 56 publications

Foreign body in the myocardium as a cause of constrictive pericarditis

Foreign body in the myocardium as a cause of constrictive pericarditis

Spontaneous migration of bullet from arm to forearm and its ultrasound guided removal

Delayed Cardiac Tamponade and Hemothorax Induced by an Acupuncture Needle

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