Friday, May 1, 2009

stuck pin

44 yo obese female arrived in the ER with chief complaint "pin stuck." Patient had no significant past medical history and actually looked well kept compared to the others in the ER that day. I was very curious as to what "pin stuck" meant.

Me: "What brought you to the hospital today?"

Patient: (figiditing with hands and looked nervous) "Well I lost my sewing needle."
Me: "Okay, were did you loose it?"

The patient proceeds to lift up her shirt and points to her lower abdomen. I got the overhead light and concentrated the light on where she was pointing but didn't see a single mark on her stomach.

Me: "Are you sure it's right there. How do you know it's there?"

Patient: "Well, I was sewing some clothes in bed and fell asleep and when I woke up, my needle was missing. Now I have a sharp pain in my stomach. I could feel it earlier in the day but the more I pushed... I think it went deeper. Now it really hurts, especially when I walk"

I honestly thought this lady was pulling my chain or something, but she was pretty large so it was possible. I ordered a KUB (stomach xray) to see if there was a needle, and sure enough she had a large sewing needle stuck in here subcutaneous tissue. It was so deep, though, that I had to consult surgery. They ordered a cat scan which showed the needle just barely penetrating the peritoneal tissue. She ended up going to the OR under fluro where she had the needle surgically removed.

I don't think she will be sewing in bed anymore!

-Doc Sensitive


Anonymous said...

I find her side of the story hard to believe. Though it's hard to believe someone would stick a needle there on purpose.

Brian and Jennifer said...

I've seen something like that happen in the does's like the people who don't realize they're pregnant until they're crowning.

GuitarGirlRN said...

We have a woman who lives in an adult home for developmentally delayed adults who comes in all the time with pins stuck in her buttocks. She does it to "punish" herself when she's "bad." She's had several abscesses and surgeries. There are two in there that have just stayed in.