A medically stable man presenting with urinary symptoms was discovered via contrast-enhanced computed tomography to have multiple metallic, needle-like foreign bodies lodged across his heart, abdominal wall, pelvis, bladder, and penis, including a 36-millimeter corroded needle embedded directly within his left ventricular wall, requiring open-heart surgery.
When physicians at the hospital evaluated the patient, his vital signs remained stable without any acute signs of distress. However, diagnostic imaging revealed an extensive distribution of foreign metallic objects. A subsequent cardiac echocardiography pinpointed a 36-millimeter metallic object inside the left ventricle that moved synchronously with the heart wall. Medical history checks revealed that a different hospital had previously extracted two foreign bodies from the man’s abdomen two years prior. This historical clinical data pointed toward self-insertion, a non-suicidal form of automutilation characterized by the deliberate introduction of objects into the body. Such behavior presents significant risks of tissue damage, severe infection, and internal migration of objects toward critical structures.
Surgical Extraction and Cardiac Complications
Given the location of the object in the pericardium—the double-walled sac enveloping the heart and major blood vessel roots—clinicians prioritized open-heart surgery. The procedure successfully removed a 36-millimeter black, rusted metallic needle from the wall of the left ventricle. Notably, the surgical team documented an absence of entry wounds or visible torso scars that could account for how the object reached the cardiac tissue. Post-operative evaluations conducted seven days after the intervention via echocardiography identified a small 3.3-centimeter deformation at the apex of the left ventricle, along with a localized blood clot against the heart wall. These findings indicated persistent myocardial irritation stemming from both the prolonged presence of the needle and the acute stress of the surgical procedure. The patient's pumping capacity was also temporarily reduced to 45%.
In Plain English: The Clinical Takeaway
- Self-Insertion: A psychological and behavioral condition involving the intentional placement of foreign objects into physical tissues, carrying severe risks of infection and internal organ damage.
- Pericardium: The double-walled sac that surrounds the heart and the roots of the large blood vessels.
- Pumping Capacity: A clinical measure of cardiac efficiency.
Long-Term Prognosis and Follow-Up
Following a nine-day post-operative inpatient recovery, the patient was discharged in stable condition. During a subsequent clinical follow-up appointment nine months later, diagnostic imaging confirmed that the apical heart deformation had not progressed. More importantly, the patient’s cardiac pumping capacity demonstrated marked improvement, rebounding from 45% up to 57%, reflecting substantial functional recovery of the myocardium.
