problem Abuse Treatment, Prevention, and Policy volume 12, Article number: 51 (2017) mention this article


Background

Illicit drug use has actually become raising public health and also social problem in the past decades worldwide. Intravenous injection has actually an elevated danger of infection. Needle embolism is a rarely complication that intravenous drug users, Retained broken needles deserve to lead to regional complications, such together infection, however they likewise have the potential to embolize to love or lung, and lead to significant complications.

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Method

We report a rare situation of one intravenous medicine user i m sorry a retained broken needle fragments in the inferior wall of the ideal ventricle.

Results

We performed a effective surgery and also give our comments and also recommendations because that illicit medicine use an international and in China.

Conclusions

Illicit Drug use becomes a global problem because of the health and social harmfulness. To assist drug addicts and carry out prevention and treatment services are the obligations and responsibilities that all medical workers.


Illicit medicine use has actually attracted an ext social concern and also become a public health concern in the past decades worldwide. Intravenous medicine users has an greater risk that infection. Needle embolism, together a rarely complication that intravenous drug users <1>, deserve to lead to neighborhood complications, such together infection. Retained damaged needles have the potential to end up being the emboli in love or lung, and also lead to severe complications. Right here we report a rare instance which a retained broken needle fragment in the inferior wall of the right ventricle, we performed a successful surgery and also give our comments and also recommendations because that illicit drug usage in China.


A 40-year-old male presented come the emergency room after a needle broke in his appropriate groin while taking heroin intravenously 20 days ago. There were neither unique symptoms nor proof of epidemic or infarction. Critical signs and electrocardiogram to be normal, and also he was hepatitis C virus (HCV) positive, a heavy user of heroin and also cocaine over 20 years. Transthoracic echocardiography revealed a kept needle fragment in the inferior wall of the ideal ventricle (Fig. 1a), and also no detectable pericardial effusion. Computed tomography confirmed the ar of a needle in the inferior wall surface of the best ventricle and also near the ventricular septum (Fig. 1b and c). Emergency open-heart surgery through a typical sternotomy under cardiopulmonary bypass was performed. Chest roentgenogram was performed by the moving bedside X-ray an equipment in the procedure room to rule out unsuspected migrate of the needle during patient positioning before proceeding v an incision. The needle to be found and removed from the inferior wall of the right ventricle (Fig. 1d and e).The patience recovered uneventfully after ~ the surgery and also was discharged house on postoperative job 6.


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Retained needle fragment in the appropriate ventricle. a Transthoracic echocardiography revealed a preserved needle fragment in the inferior wall surface of the best ventricle, and no detectable pericardial effusion. b and c Computed tomography confirmed the ar of a needle in the inferior wall of the appropriate ventricle and near the ventricular septum. d and also e The needle to be found and removed from the ideal ventricle


Needle embolism is one infrequent complication that intravenous drug individuals (IDUs) <1>. Damaged needles take place most typically when the needle separates and comes apart from the hub. Inflammation and infection after needle embolism are reasonably common in regional wound site. If the main embolim the needle fragmentscan potentially reason serious complications such together cardiac perforation, pericarditis, infective endocarditis, arrhythmias, and also pulmonary abscess <1>. In many cases, it is recommended to remove the needle when the embolism is found in stimulate to stop delayed complications <2>.

Illicit drug usage is an intractable and worldwide public health problem. Follow to the people Drug Report 2016 <3>, 250 million that people in between the periods of 15 and 64 years supplied drugs in 2014. End 29 million people who offered drugs experience from drug usage disorders, of whom 1 in 6 is in treatment. What’s worse, the most current data available showed the 12 million civilization had a history of injecting drugs around the world <4>.Compared with the traditional way of acquisition drugs, IDUs room exposed to an ext health-related harms and also have a high hazard of premature death. Negative health conditions, unsterilized injecting sites and also drug dissolve agents are the leading causes of bacterial infection. Due to the fact that of poor or convenience, sharing and also repetitive use of needles is a common phenomenon i m sorry is the main reason of human being Immunodeficiency Virus (HIV) and HCV infection. About fifty percent of IDUs are approximated to re-publishing needles global <5>. A recent surveillance surveys among IDUs in China likewise showed the 47.7% reported ever sharing needles <6>. The statistics from human being Drug Report 2016 reflects that 14% of IDUs are living v HIV and 50% through hepatitis C in 2014 <3>.Several researches have shown that IDUs have actually a disproportionate ubiquity (60–80%) of HCV infection globally <7,8,9>. The most current data available in China likewise showed the in 2011, 67% the IDUs are living v HCV <8>. In addition, studies have actually reported that human being often have actually risky sexual behaviors after injecting opiates, resulting in the threat of HIV infection <7,8,9>.

A cross-sectional survey research in unified Kingdom released in 2002 discovered that 20% of IDUs had actually experienced a broken needle during the food of your injecting careers <10>. Given the an excellent number the IDUs in China, succeeding needle embolization may be more common than it appears, an especially as drug misusers often tend to prevent hospital uneven seriously ill. Damaged needles room hidden dangers for IDUs and main needle embolism could even an outcome in major complications in heart and also lung. For this reason it is necessary to boost the familiarity v needle embolism, as an unusual however life-threating complication the IDUs.

In Mainland China and also other districts in Asia, compulsory medicine rehabilitation is a major strategy for medicine users. However, harm reduction ideologies such as methadone maintenance treatment (MMT) and also needle-syringe exchange projects (NSPs) room widely supported in current years. In Mainland China, a full of 767 methadone maintenance therapy clinics had been collection up in 28 districts by the end of 2014 <11>.While in Changsha, the city where our hospital located, 1990 patients got treatment in a total of 3 MMT clinics in 2013 <12>. Meanwhile, needle-syringe exchange tasks were pushed forward in Mainland China. In 2014, NSPs were held in 14 provinces, with 814 needle exchange sites. End 56,000 drug individuals participated in the tasks and an ext than 11 million needles and syringes to be handed out <11>.

It was essential for this patient to have drug rehabilitation therapy after being discharged. We recommended that to to visit MMT and NSP. Follow to number of studies in China, MMT can substantially reduce criminal activity and improve employment rate and also social well-being, that helps drug individuals to resume societal and also familial attributes <6, 13, 14>. And also NSPs lessened levels that injecting frequency, repetitive use and also sharing that injecting equipment amongst Chinese IDUs.


Illicit drug usage becomes a global problem since of the health and also social harmfulness. To aid drug addicts and carry out prevention and treatment solutions are the obligations and responsibilities of all medical workers.


HCV:

Hepatitis C virus

HIV:

Human Immunodeficiency Virus

IDUs:

Intravenous medicine users

MMT:

Methadone maintain treatment

NSPs:

Needle-syringe exchange projects


References


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Acknowledgements


Thank Changming Tan and also Xinmin Zhou for your Help.

Funding

None.

Availability the data and also materials

The datasets during and also analyzed throughout the existing study accessible from the corresponding author on reasonable request.


Affiliations

Department that Cardiovascular Surgery, The 2nd Xiangya Hospital, main South University, Changsha, Hunan, People’s Republic of China

Xianming Fu

Mental health Institute of The 2nd Xiangya Hospital, central South University, Changsha, Hunan, People’s Republic of China

Kai Chen

Department of Cardiovascular Surgery, The second Xiangya Hospital, central South University, Changsha, Hunan, People’s Republic of China

Xiaobo Liao

Department that Cardiovascular Surgery, The second Xiangya Hospital of main South University, 139. Renmin Road, Changsha, Hunan, 410011, People’s Republic of China

Kangjun Shen


Contributions

XMF conceived and also analyzed the data. XMF, KC and KJS were significant contributors in composing the manuscript. XBL and also KJS checked and also approved the manuscript. All authors read and also approved the last manuscript.

Corresponding author

Correspondence come Kangjun Shen.


Ethics approval and also consent to participate

The investigation conforms to the values approved by the principles committee that the second Xiangya Hospital. We derived written informed consent indigenous the patient.

Consent because that publication

The patient offers him consent for the information around himself to appear in the journal and also associated publications.

Competing interests

The writer declare that they have no completing interests.

Publisher’s Note

Springer Nature stays neutral v regard come jurisdictional cases in published maps and institutional affiliations.

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Cite this article

Fu, X., Chen, K., Liao, X. Et al. Situation report: surgical removal that a migrated needle in right ventricle of one intravenous drug user. Subst Abuse treat Prev plan 12, 51 (2017). Https://doi.org/10.1186/s13011-017-0134-1

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Received: 06 might 2017

Accepted: 14 November 2017

Published: 08 December 2017


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