Constrictive pericarditis resulting from the transpulmonary migration of an inhaled nail.

Haas, Richard; Lea, Richard; Conway, N.

doi:10.1136/thx.34.4.559

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Dr Robert H Cleveland's Diagnosis1

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1988

1998

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“…[42][43][44] A similar mechanical effect may lead to the migration of an inhaled inflorescence or nail from the lung into the pericardium, diaphragm, or skin. [45][46][47] Bronchi proximal to, surrounding, and distal to the impacted plastic fastener had abnormal contours and diameters, densely sclerotic walls with destruction of cartilage and hypertrophy of bronchial arteries, and inflamed and fibrotic mucosa (Fig. 6).…”

Section: Dr Robert H Cleveland's Diagnosismentioning

confidence: 99%

Case 31-1998

Cleveland¹,

Mark²

1998

N Engl J Med

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Section: Dr Robert H Cleveland's Diagnosismentioning

confidence: 99%

Case 31-1998

Cleveland¹,

Mark²

1998

N Engl J Med

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Chronic constrictive pericarditis caused by self-mutilation with sewing needles. A case report and review of published reports.

Keogh¹,

Oakley²,

Taylor³

1988

Heart

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SUMMARY A 34 year old woman with a history of self-mutilation developed severe constrictive pericarditis with sterile, calcified intrapericardial abscess cavities as a result of inserting sewing needles into her chest seven years previously. After pericardiectomy she made a good recovery.In peacetime needles are the most common foreign bodies found in the pericardial sac, whereas bullets and shrapnel become more common in times of war.' In the nineteenth century it became fashionable to attempt suicide by driving a long pin, needle, or skewer into the heart. Admiral Villineuve who commanded the French fleet at Trafalgar was taken prisoner by the English. After his release he returned to Rennes from where he sent a message to Napoleon announcing his return to French soil. Suffering from guilt and depression, and failing to receive a reply from Napoleon, whom he knew to be more than a little displeased, he killed himself by driving a long needle six times into his heart. In 1868 Fischer described 452 patients wounded in the heart or great vessels and showed that such wounds were not always fatal.2 He recorded 319 penetrating wounds, mainly stab and gunshot, but 44 were puncture wounds. Of these, 28 were caused by various types of needles and only 10 patients survived the initial injury.In 1899 Loison reported a further series of 61 penetrating injuries; in 23 cases these were caused by needles. Some of these patients were symptomless while others died suddenly for unknown reasons.3 Fourteen (61 %) died; eight of haemorrhage with tamponade, and one of infection. In five the cause of death was not known.

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Constrictive pericarditis resulting from the transpulmonary migration of an inhaled nail.

Cited by 2 publications

References 6 publications

Case 31-1998

Case 31-1998

Chronic constrictive pericarditis caused by self-mutilation with sewing needles. A case report and review of published reports.

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