Successful Localization and Removal of an Aberrant Sewing Needle in the Posterior Mediastinum: Usefulness of Multidetector Computed Tomography

Yoshizawa, Kosuke; Ohno, Nobuhisa; Maeda, Toshi; Kato, Otohime; Ueno, Go; Fujiwara, Keiichi

doi:10.1016/j.cjca.2019.01.012

Cited by 2 publications

(6 citation statements)

References 5 publications

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“…Cardiac foreign bodies vary from bone cement, air bullets, metal splinters, and stents to needles and paperclips. [1][2][3][4][5] Penetration of the heart or left chest wall by sewing needles is extremely rare, and some of these incidents have been self-inflicted injuries resulting from depression or drug abuse. In such cases, the inability of victims to cooperate makes the taking of medical history difficult, 2 causing problems in diagnosis at the initial stage and thus delaying timely treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac foreign bodies vary from bone cement, air bullets, metal splinters, and stents to needles and paperclips 1–5 . Penetration of the heart or left chest wall by sewing needles is extremely rare, and some of these incidents have been self‐inflicted injuries resulting from depression or drug abuse.…”

Section: Discussionmentioning

confidence: 99%

“…Nonenhanced CT can detect these radiopaque foreign bodies with high sensitivity and specificity, and electrocardiography-gated multidetector CT can reveal the foreign body's location and its relationship with the surrounding tissues or organs. 3 TTE is capable of demonstrating the location and morphological character of the foreign body. Furthermore, a bedside cardiac ultrasound enables the function of the heart to be visualized and evaluated for these patients with unstable vital signs.…”

Section: Discussionmentioning

confidence: 99%

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Removal of sewing needles from interventricular septum under the guidance of multiple imaging modalities

Liu

2022

Journal of Cardiac Surgery

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Background: Penetration of the interventricular septum (IVS) by a sharp foreign body is a rare and potentially life-threatening event.Methods: We present the case of a 43-year-old female who had thrust four embroidery needles into her left chest wall while experiencing hallucinations after using an illegal drug. One needle had penetrated the heart and was embedded in the IVS, as confirmed by intraoperative transesophageal echocardiography (TEE), and one needle had lodged in the left chest wall. Results:The sewing needles penetrating the IVS and chest wall were successfully removed under the guidance of TEE and a cardiopulmonary bypass without crossclamping the aorta or opening the heart. Conclusion:The sewing needles embedded in the IVS and left chest wall were successfully removed with the aid of multiple imaging modalities.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Removal of sewing needles from interventricular septum under the guidance of multiple imaging modalities

Liu

2022

Journal of Cardiac Surgery

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“…Some other imaging modalities, such as ultrasonography and fluoroscopy, might facilitate localization. 17 The modality and equipment of the procedure should be chosen according to the FB shape, size, location, anatomical structure, and compression time. The O-type hybrid knife was used in the children cases to avoid inadvertent transmural injury as children have thinner muscular layer than adult patients.…”

Section: Discussionmentioning

confidence: 99%

“…The penetration point is located by its relation to surrounding vital structures and confirmed by the overlying scar of granulation or fibrous tissue and mucopurulent secretions. Some other imaging modalities, such as ultrasonography and fluoroscopy, might facilitate localization 17 …”

Section: Discussionmentioning

confidence: 99%

Endoscopic removal of entirely embedded esophagus‐penetrating foreign bodies (with video)

Wang

Liu

et al. 2021

J of Gastro and Hepatol

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Background and Aim: Traditionally, surgery is the only choice for esophageal foreign bodies (FBs) penetrating into the mediastinum or cervical para-esophageal space. Recent progress in endoscopic techniques and devices has made it possible to perform endoscopic procedures in the mediastinum. Here, we describe a novel method to remove the entirely embedded esophagus-penetrating FBs through an endoscopic approach. Methods: Patients who underwent endoscopic removal of entirely embedded esophagus-penetrating FBs were prospectively enrolled between December 2018 and June 2020. All procedures were performed by using five major steps: localization of the FB; mucosal incision; wound debridement, myotomy, and FB exposure; FB extraction; and closure of the esophageal wound. Results: A total of five cases of entirely embedded esophagus-penetrating FBs were evaluated, two in children and three in adults. All FBs were successfully removed and extracted using a therapeutic endoscope and a hook knife or a hybrid knife and a grasping forceps as accessories. The average procedure time was 19.0 ± 12.4 min (range 10-40 min). The major surgical procedure was avoided in all patients. The average length of hospital stay was 3.8 ± 2.5 days (range 2-8 days). There were no severe short-term adverse events after all procedures. During the 1 month and 3 months follow-up, no patient developed long-term adverse events including stenosis of the esophagus and fistula formation. Conclusions: Endoscopic approach was a safe and effective way to remove entirely embedded esophagus-penetrating FBs.

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Successful Localization and Removal of an Aberrant Sewing Needle in the Posterior Mediastinum: Usefulness of Multidetector Computed Tomography

Cited by 2 publications

References 5 publications

Removal of sewing needles from interventricular septum under the guidance of multiple imaging modalities

Removal of sewing needles from interventricular septum under the guidance of multiple imaging modalities

Endoscopic removal of entirely embedded esophagus‐penetrating foreign bodies (with video)

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