2017-06-28 05:07:26 UTC

The Case of the Missing Acupuncture Needle – Solved by 3-D CT

Researchers describe the loss and internal migration of an acupuncture needle, and its recovery using 3-dimensional reconstruction computed tomography (CT), in the July issue of Gastroenterology.

An-qi He et al, report the case of a 62-year-old woman in China who presented with abdominal pain in the left lower quadrant. Her “needle-like abdominal pain” was aggravated when changing body position and during defecation, but remitted when lying flat.

She had been receiving acupuncture therapy at the right Huantiao (GB30) acupoint, one-third of the distance from the femoral greater trochanter peak to the sacral hiatus. An abdominal CT scan revealed a metallic density shadow in the left lower quadrant of the abdomen.

He et al discovered that 2 weeks before admission, after acupuncture therapy, the patient had felt right hip pain and restricted movement in the right lower limb. The hip pain gradually ceased, but then moved to the left lower abdomen.

A CT scan with 3-dimensional reconstruction was performed to pinpoint the needle location (Figure B). Focusing on the area where it might be and gently removing the intestine, the authors found the needle in the sigmoid mesocolon—a 2-cm segment was visible. The needle, about 8.5 cm long, was extracted by laproscopy (Figure C).

He et al explain that although acupuncture is relatively safe, there have been reports of patients with stuck needles, sometimes causing symptoms.

This was a rare case of an acupuncture needle migrating from the buttock to the abdomen. The authors propose that the needle entered the pelvic cavity through the right greater sciatic foramen, passed the anterior wall of the bladder to the left, and ultimately inserted into sigmoid mesocolon, skillfully avoiding vessels and nerves all the way (Figure D).

They attributed the needle’s migration to muscle spasm, changing posture, and the acupuncture needle’s flexibility.