Gladman Joshua
Central and North West London NHS Foundation Trust, London, UK.
BMJ Case Rep. 2019 Feb 6;12(2):e226220. doi: 10.1136/bcr-2018-226220.
A female intravenous drug user was reviewed in A&E following a deliberate overdose. After claiming to have swallowed a razor blade, an abdominal radiograph was performed; this showed a linear metallic density projected over the right side of the pelvis, eventually identified as a needle fragment. Subsequent CT imaging revealed three additional needles situated within the groin. Duplex assessment also identified bilateral arteriovenous fistulae. The patient remained asymptomatic and was managed conservatively. She could recall several occasions when a needle had broken while injecting. This scenario was more likely if the needle had been used many times previously, causing it to become blunt and bent. There are cases reported of adverse patient outcomes secondary to broken needle fragments but awareness among medical professionals remains poor.
一名女性静脉注射吸毒者在蓄意过量用药后被送往急诊室接受检查。在声称吞下剃须刀片后，进行了腹部X光检查；结果显示骨盆右侧有一条线性金属密度影，最终确定为针头碎片。随后的CT成像显示腹股沟内还有另外三根针头。双功超声评估还发现双侧动静脉瘘。患者无症状，接受了保守治疗。她能回忆起几次注射时针头折断的情况。如果针头先前使用过很多次，变得钝且弯曲，那么出现这种情况的可能性就更大。有报道称患者因针头碎片而出现不良后果，但医学专业人员对此的认识仍然不足。
