Trans-sternal cardiac injury caused by a hooked needle

• Published in: Emergency medicine journal : EMJ Vol. 22; no. 10; pp. 751 - 753
• Main Authors: Yanar, H, Aksoy, M, Taviloglu, K, Unal, E S, Kurtoglu, M, Nisli, K
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine 01.10.2005; BMJ Publishing Group LTD; BMJ Group
• Subjects: Abdomen; Blood; cardiac injury; Case Report; Child, Preschool; Children & youth; Female; Foreign Bodies - complications; Foreign Bodies - diagnostic imaging; Foreign Bodies - surgery; Heart; Heart Injuries - diagnostic imaging; Heart Injuries - etiology; Heart Injuries - surgery; Heart Ventricles - injuries; Humans; Injuries; Needles; Ostomy; pediatric; Radiography; Surgery; trans-sternal; Trauma; Wounds, Penetrating - diagnostic imaging; Wounds, Penetrating - etiology; Wounds, Penetrating - surgery
• ISSN: 1472-0205; 1472-0213
• DOI: 10.1136/emj.2004.014779

Cardiac injuries remain the most challenging of all injuries seen in the field of trauma surgery. Penetrating injury to the heart generally occurs less frequently than blunt injury and most commonly injures the large anterior right ventricle. We present an unusual, and to our knowledge a previously unreported, cause of cardiac penetrating trauma in a child, involving a hooked needle (a 15 cm long, metallic device usually used for crocheting or lacemaking). A ventricular septal defect was managed conservatively shortly after the primary cardiorrhaphy. Evaluation methods for this rare presentation and its possible surgical treatments are discussed.