Child abuse by percutaneous insertion of sewing needles

Sewing needles in the lungs of children: Two case reports

RATIONALE

Foreign bodies are common in children. However, it is uncommon to have a "sewing needle" penetrating the body percutaneously rather than via a natural orifice. Such cases have been reported from across the world, with needles being found in regions such as the cranium, abdomen, limbs, neck, scrotum, and buttocks. Few cases with a needle inserted in the lung have been reported.

PATIENT CONCERNS

We present 2 cases where the needles were found in the chest wall/lung because of suspected child abuse. In the first case, foreign bodies were present in the chest wall and the lung. In the other case, the pointed end was oriented towards, and was very close to, the great arteries.

DIAGNOSES

Both cases were diagnosed incidentally when chest X-ray was being performed for other reasons.

INTERVENTIONS

Surgery was indicated for both cases, and the needles were excised uneventfully.

OUTCOMES

The postoperative course in both cases was uneventful.

LESSONS

It is worth noting that in both cases, neither the guardians nor the victims themselves could tell when and how the needles got lodged in the lungs. Collective information suggested that these 2 cases probably involved child abuse. Child abuse in China has long been underestimated and underrecognized. There is still much left to do to tackle this important issue, especially in rural areas.

Needle Insertion in a Child: A Rare Form of Child Abuse

Needle insertion is a rare form of child abuse that, though prevalent in the society as an attempted infanticide/homicide, remains undiagnosed and underreported. One should have strong suspicion for occurrence of child abuse in a child with history of needle injury. Here, we report an unusual case of 3-month-old boy with history of hypodermic needle extrusion from multiple sites of body and suspicion of possible child abuse.

Needle Insertion in a Child: A Rare Form of Child Abuse

Needle insertion is a rare form of child abuse that, though prevalent in the society as an attempted infanticide/homicide, remains undiagnosed and underreported. One should have strong suspicion for occurrence of child abuse in a child with history of needle injury. Here, we report an unusual case of 3-month-old boy with history of hypodermic needle extrusion from multiple sites of body and suspicion of possible child abuse.

Foreign Body-Related Extremity Trauma in Children: A Single-Center Experience

The extremity foreign body in a child has propensity of getting missed or mistaken diagnosis. We report our experience of extremity foreign body trauma in order to increase awareness of this disease entity. The retrospective series of 24 retained foreign bodies was based on a 10-year chart review of emergency data (ICD code Z18). Patients with both upper and lower limb affections were included. Patients with ocular, otolaryngeal, tracheobronchial, gastrointestinal, and axial foreign bodies were excluded from the study. Male predominance (M:F = 20:4), young patient age (mean 6.8 years), variable lag period for consultation (range 3 h-8 years), and majority lower limb affection (58%; foot [7; 29%] and knee [5; 20.8%]) were some characteristics of extremity foreign bodies trauma. The foreign bodies reported were metallic needle (7; 29%), rubber band (3; 12.5%), pellets (3; 12.5%), bangle glass (2; 8%), glass pieces (2; 8%) "dhaga," wooden twig, wooden thorn, ceramic earthen pot pieces, stapler pin, broomstick, and cracker piece in one case each (1; 4%). Postremoval, the wound healing was uneventful in all patients. Foreign body-related extremity trauma in children is a rare event. It has its own set of characteristics and differential diagnosis. Familiarity with the regional practices and customs is must to establish the circumstances/nature of the foreign body injury. The foreign body should preferably be removed in a well-equipped setting.

Unexpected foreign body in the leg of an 8-month-old child

Accidents and injuries associated with foreign bodies are important causes of childhood mortality. Diagnosis can be facilitated by obtaining a detailed history, performing a physical examination and utilising simple imaging methods. We report a case involving a fragmented sewing needle in the left leg of an 8-month-old male infant. He was admitted to our clinic with diffuse pain in the left leg, limitation of leg movements and an inability to stand. The patient was successfully treated with open surgery under fluoroscopy. Soft tissue foreign bodies and potential child physical abuse should be considered in children with ambiguous symptoms and unusual skin lesions. Parents should be educated on prevention of household accidents involving children. Penetration of sewing needles into the body has been rarely reported in the literature. We thus report this case to draw attention to the complications and morbidity associated with a delayed diagnosis in such cases.

Intra-abdominal insertion of sewing needles: a rare method of child abuse

The insertion of sewing needles into the abdominal cavity is an uncommon form of child abuse. We report a 2-and-a-half-year-old boy with 2 intra-abdominal sewing needles that were discovered during the evaluation of chronic abdominal pain and vomiting. This case report illustrates the wide range with which abusive injury can present in children. Pediatricians need to be alerted to this newly-recognized and the increasing form of child abuse so that they examine and diagnose their patients appropriately.

To remove or not remove...asymptomatic sewing needle within hepatic right lobe in an infant

The ingestion or accidental insertion of foreign bodies is extremely rare before 6 months of age. We report the case of a 3-month-old infant with a sewing needle into the right hepatic lobe, without symptoms. The extraction was performed through laparotomy. The issue is revisited, and the decision making tree is discussed.