Embolization of illicit needle fragments

Area of Science:

• Medical Case Reports
• Radiology
• Interventional Radiology

Background:

• Complications from retained or embolized foreign bodies (FB) are primarily documented with intravascular devices, necessitating retrieval.
• Embolization of hypodermic needle fragments in intravenous drug abusers is rare and its management remains controversial.
• Only ten cases of hypodermic needle fragment embolization have been reported.

Observation:

• A case of a hypodermic needle fragment embolizing to the lung from a forearm vein in an intravenous drug abuser is presented.
• Embolization occurred during an attempted removal of the needle fragment from the injection site vein.
• The needle fragment lodged in the lung parenchyma and was managed conservatively (left in situ).

Findings:

• The patient experienced no complications related to the retained needle fragment during a 10-month follow-up period.
• Conservative management of a lung-lodged hypodermic needle fragment in an intravenous drug abuser can be a viable option.
• This case adds to the limited literature on the natural history and management of such rare embolization events.

Implications:

• Highlights the need for careful consideration of management strategies for foreign body emboli, especially in specific patient populations.
• Suggests that conservative management may be appropriate for asymptomatic hypodermic needle fragments in the lung.
• Contributes to understanding the potential outcomes and risks associated with foreign body embolization in intravenous drug users.