2008 Volume 37 Issue 4 Pages 244-246
A-23-year-old man, with intellectual disability and history of self-inflicted injuries, presented with chest pain. A 3mm “picked” wound in the left chest was observed on physical examination. Chest computed tomography revealed a needle in the pericardium. Emergency surgery was performed by median sternotomy. At first we could not find the needle because it was completely buried in the heart, but when the posterior wall of the heart was exposed, the head of the needle appeared protruding from the posterior wall. It was removed and the wound of the posterior wall was closed with direct mattress sutures without cardio-pulmonary bypass. On inspection, the needle was 34mm long.
