Cardiac perforation as a rare complication of acupuncture

Wigger, Olivier; Stortecky, Stefan; Most, Henriette; Englberger, Lars

doi:10.1093/eurheartj/ehv171

Cited by 5 publications

(4 citation statements)

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“…Upon researching this case, it was discovered that this was not the first case in which a patient had a needle fragment discovered in their body following acupuncture treatment [7,[9][10][11][12][16][17][18][19][20][21][22][23][24][25][26][27]. In the United States, acupuncture needles (single-use disposable filiform needles) are regulated by the Federal Department of Agriculture as a 'medical device,' requiring only that the needles must be biocompatible and sterile [28].…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the AE listed above as a result of acupuncture, previous case studies have documented AE where either acupuncture needles or singleuse disposable filiform needles have been found in patients' bodies, including in the abdomen [16], superciliary arch [17], left ventricle [18], right ventricle [9], lung [19], duodenum [20], bladder [10], ureter [21], lumbar spinal canal [22], the L5 nerve root [23], upper cervical spinal nerve root [12], medulla oblongata [24], median nerve [25], and throat [26]. This case study describes another such AE suffered by a patient presenting to a physical therapy clinic after having two fragments of singleuse disposable filiform needles surgically removed from his neck, with one of the fragmented needles having migrated over three centimeters from its original location to within two millimeters of the patient's vertebral artery following his international airplane flight.…”

Section: Introductionmentioning

confidence: 99%

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Acupuncture gone awry: a case report of a patient who required surgical removal of two single-use filament needles following acupuncture treatment

Snyder

2019

Journal of Manual & Manipulative Therapy

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Background: Acupuncture and dry needling are increasingly popular treatment modalities used to treat pain around the world. This case report documents the clinical history of a patient who presented to an outpatient physical therapy clinic following surgical removal of two single-use filament needles that fractured in the patient's neck during acupuncture treatment.Case Description: The purpose of this case report was to highlight a rare adverse event following acupuncture treatment. The patient received the acupuncture treatment from a practitioner licensed in acupuncture, while on an international business trip. Following the acupuncture treatment, the practitioner realized that a needle had fractured and remained in the patient's neck. After failing to retrieve the needle, the patient was sent for imaging. Radiograph revealed that the patient had two needle fragments located in his cervical tissue. After determining that the needles did not pose an immediate threat, the patient boarded a flight home to the United States. Following his flight, the patient presented to an American hospital where it was discovered that the needle fragments had migrated during the flight, with one needle now located 2 mm from the patient's vertebral artery. Surgical intervention was required to retrieve the needles, resulting in the patient needing physical therapy to increase cervical range of motion and mediate pain relief. Outcomes: The patient suffered a setback in his treatment of chronic neck pain that resulted in decreased cervical range of motion and increased pain. Discussion: Clinicians utilizing single-use filiform needles in their practice, whether for acupuncture or dry needling, should be aware of the potential for this type of adverse event. Further, to minimize the risk of similar adverse events occurring in the future, clinicians should make sure that they are using high quality needles and make a habit of counting in and counting out the needles that they use to verify that all needles are accounted for.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acupuncture gone awry: a case report of a patient who required surgical removal of two single-use filament needles following acupuncture treatment

Snyder

2019

Journal of Manual & Manipulative Therapy

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“…Other incidents (less frequent) reported in the literature but not less important are cardiac tamponade [21,39,51,75,77], granulomas [23], fistulas [24,38], necrosis [25,42,85], infections [27,57,119], abscesses [27,45,61,71,74,76], pneumoretroperitoneum [32], hemorrhages [35], hemopericardium [37], haematomas [40,64,67,109,111,117], chilotorax [41], organ perforation [48,60], needle rupture [53,55,117], hemiplegia [54], hemothorax [56], peritonitis [66], cellulitis [72], hypokalemic paralysis [84], nerve injury [86,99,102,107,108,110,116], weakness …”

Section: Most Prevalent Adverse Effectsmentioning

confidence: 99%

Needling Therapies in the Outpatient Care: Adverse Effects

Llamas-Ramos¹,

Llamas-Ramos²

2022

Ultimate Guide to Outpatient Care

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The invasive techniques have been used for many years. There is a lot of literature on the advances that have been made, as well as the adverse effects or possible complications that have occurred during the performance of these treatments. Acupuncture and injections (saline, anesthetics, corticosteroids or botulinum toxin) have reported several cases of complications. Dry needling is also beginning to have several publications of this type. The objective of this chapter is to summarize the articles published in relation to adverse effects of needling therapies to promote a good practice and knowledge. Original articles in form of randomized controlled trials, case reports and reviews relating adverse effects and possible complications due to invasive/needling techniques: acupuncture, injections and dry needling have been included. 102 articles met the inclusion criteria between January 2000 and January 2020. The first limitation found in the literature was the huge variety of cases, therapists and incidents to generalize. As a conclusion we can stated the importance of a good knowledge of the anatomy and its variants, the correct application of these techniques and a continuous training of these therapists must be essential.

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“…The majority of reported cases of cardiovascular injuries due to needle perforation involved individuals with psychiatric disorders due to self-harm or self-mutilation (6). Additional reported cases in the literature were due to therapeutic complications, such as pericardiocentesis (7), acupuncture (8), needle embolization after intravenous drug use (9)(10)(11), and swallowing of needles (12). Death still remains an uncommon outcome; in one study, it was reported in only 2 out of 40 individuals (6).…”

Section: Introductionmentioning

confidence: 99%

Postmortem Imaging of an Unusual Case of Fatal Heart and Lung Perforation Due to Self-Treatment

Ali¹,

Mourtzinos²

2022

Academic Forensic Pathology

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Intentional or accidental cardiothoracic injuries caused by needles and pins are rare and commonly reported in individuals with psychiatric conditions or intravenous drug users. Although rare, these cases could result in serious injury during the performance of an autopsy and highlight the importance of post-mortem radiology. Therapeutic complications with cardiac perforation have been reported due to pericardiocentesis and acupuncture. The majority of reported cases were not fatal and some had a prolonged asymptomatic period of weeks or even years after insertion. Needles or other sharp objects can reach the cardiovascular system directly through the chest wall, indirectly from any segment of the gastrointestinal tract after swallowing needles, or through migration of broken needles from distant injection sites in intravenous drug users. We report a case of rapidly fatal cardiopulmonary injuries following “self-treatment” to “pop” a cyst with a piercing needle. The scene, autopsy, computed tomography, and digital x-ray findings of this unique case are discussed with a review of selective literature. In this case, the right lung and heart showed multiple perforations, possibly resulting from heartbeats or respirations pushing the organs against the needle. To our knowledge, perforations in this setting of “self-treatment” have not been previously reported in the literature.

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Cardiac perforation as a rare complication of acupuncture

Cited by 5 publications

References 0 publications

Acupuncture gone awry: a case report of a patient who required surgical removal of two single-use filament needles following acupuncture treatment

Acupuncture gone awry: a case report of a patient who required surgical removal of two single-use filament needles following acupuncture treatment

Needling Therapies in the Outpatient Care: Adverse Effects

Postmortem Imaging of an Unusual Case of Fatal Heart and Lung Perforation Due to Self-Treatment

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