Delayed Staple Penetration of the Heart: Transthoracic Migration with Late Tamponade

Wolfson, Robert H.; Moore, Ernest E.; Way, Charles W. Van

doi:10.1097/00005373-198603000-00017

Cited by 5 publications

(4 citation statements)

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“…For Wolfson et al, (1986) these foramina are typically detected through roentgenograms, whereas to Halvorsen et al and Peuker et al it cannot be identified by standard chest X-ray films. Using computed tomography (CT) scan, Stark (1985) found this variation in 4.8% of his sample.…”

Section: Discussionmentioning

confidence: 97%

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: 97%

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

et al. 2012

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“…Also reported are coro nary arteriovenous fistulae, coronary artery aneurysm, myocardial infarction, and ven tricular septal defect [1,[6][7][8][9][10][13][14][15][16][17][18], Such foreign bodies are occasionally discovered on roentgenograms without any reported symptoms [ 14,15]. This is the first report of delayed cardiac tamponade and hemothorax due to a very' fine acupuncture needle which was barely detectable on the chest roentgen ogram.…”

Section: Discussionmentioning

confidence: 98%

“…The presence of needles in the heart and great vessels has previously been confirmed on chest roentgenography [1][2][3][4][5][6][7]. as well as M-mode [11] and two-dimensional echocar diography [5,12], Although the image of sev eral needles on chest and abdominal roent genograms raised suspicion, the needle caus ing the traumatic cardiac tamponade located at the base of pulmonary artery could not be detected on the roentgenogram.…”

Section: Discussionmentioning

confidence: 99%

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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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