A female intravenous drug user was reviewed in A&E following a deliberate overdose. After claiming to have swallowed a razor blade, an abdominal radiograph was performed; this showed a linear metallic density projected over the right side of the pelvis, eventually identified as a needle fragment. Subsequent CT imaging revealed three additional needles situated within the groin. Duplex assessment also identified bilateral arteriovenous fistulae. The patient remained asymptomatic and was managed conservatively. She could recall several occasions when a needle had broken while injecting. This scenario was more likely if the needle had been used many times previously, causing it to become blunt and bent. There are cases reported of adverse patient outcomes secondary to broken needle fragments but awareness among medical professionals remains poor.
- drugs misuse (including addiction)
- public health
- vascular surgery
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Contributors JG (corresponding author) completed the planning, literature search and write-up of this case report.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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