RESUMEN
INTRODUCTION: Penetrating thoracic trauma with retained foreign bodies, such as needles, is rare. These injuries present management challenges due to diverse aetiologies and potential complications, including tension pneumothorax, cardiac tamponade, and major haemorrhage. Cardiac penetration can result in arrhythmias, ischaemia, valvular and septal defects. Effective management depends on patient status, injury mechanism, and resources. CASE PRESENTATION: A 2-year-old girl presented with left chest wall pain after falling. Examination revealed a small puncture wound and a rhythmic bulge at the left fifth intercostal space. She was stable, with normal vitals and no respiratory distress. Imaging, including chest X-ray and echocardiography, revealed a 40 mm needle in the left pleural space, contacting the pericardium near the left ventricular apex. She was transferred to a paediatric cardiothoracic centre, where a left anterolateral thoracotomy confirmed the needle's location and facilitated its removal. She recovered without complications. DISCUSSION: Retained foreign bodies in the heart can arise from various injuries and pose complications from asymptomatic to life-threatening. This case underscores the importance of early assessment, particularly in children where symptoms may be subtle. Essential imaging aids in diagnosis and surgical planning. The surgical approach was context-specific, favouring minimally invasive options when feasible. Trauma networks play a crucial role in improving outcomes by ensuring timely access to specialized care. CONCLUSION: This case highlights the importance of early assessment and intervention in paediatric patients with penetrating thoracic trauma involving foreign bodies. The successful outcome was due to prompt recognition, accurate imaging, and coordinated efforts within a specialized trauma network.
RESUMEN
Cardiac foreign bodies (FBs) are rare. Their etiology can be attributed to penetrating injuries although they are also often found incidentally. The approach for removal of these FBs is variable and patient dependent. Although there is debate regarding indications for removal, there is a general consensus that symptomatic FBs presenting acutely, as well as asymptomatic FBs posing a greater risk of complication to the patient, should be removed. We present the case of a 14-year-old patient with a cardiac FB and a step-wise approach for removal.
Asunto(s)
Cuerpos Extraños , Lesiones Cardíacas , Corazón , Heridas Penetrantes , Femenino , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/cirugía , Lesiones Cardíacas/diagnóstico , Lesiones Cardíacas/cirugía , Humanos , Heridas Penetrantes/diagnóstico , Heridas Penetrantes/cirugía , Adulto JovenAsunto(s)
Migración de Cuerpo Extraño/etiología , Corazón , Dependencia de Heroína/complicaciones , Agujas , Abuso de Sustancias por Vía Intravenosa/complicaciones , Adulto , Migración de Cuerpo Extraño/diagnóstico por imagen , Corazón/diagnóstico por imagen , Humanos , Masculino , Tomografía Computarizada por Rayos XRESUMEN
Inferior vena cava filters have gained increasing popularity in recent decades and knowledge on rare complications becomes vital to practicing physicians. A 30-year-old African American male with diabetes mellitus, hypertension, end-stage renal disease, history of deep venous thrombosis and placement of venacaval filter who was seen in the cardiology clinic for cardiac risks stratification prior to renal transplant. Patient denied any cardiac symptoms. A transthoracic echocardiogram was performed and showed two linear echoes bright densities in the right atrium and right ventricle embedded which was later found to be fractured filter struts by computed tomography. We discuss the various outcomes associated with non-retrieval of retrievable inferior vena cava filters.
RESUMEN
Sewing needles are rare causes of penetrating cardiac injury. Suicidal attempt, accidental penetration, domestic violence, and child abuse are likely causes for such injury. 1 Owing to their sharp nature, needles can rapidly migrate through the tissues. Fatalities are due to cardiac tamponade, infection, peripheral embolism, and valve dysfunction.