[A case report of recurrent self inserted needle in heart].

A 17-year-old female who had, on two occasions, inserted a total of 7 needles into her heart and chest wall, resulting in autolesion on both occasions, was examined. On the first occasion, because the needle end was recognizably protruding from the right ventricle, we successfully removed the needle without using ECC. No complications arose prior to discharge, after which she regularly visited the psychiatric department for treatment. Two months after discharge, she again inserted needles into her chest wall and was admitted to hospital. At that time, five needles were evident in the chest wall. During preparation for removal of the needles under local anesthetic, she escaped from the room. When found in a ward several hours later, six needles were embedded in her chest wall, the sixth, most recently inserted needle was an injection needle. Due to the depth to which the needle had been inserted in the heart, neither the point nor end were visible, and thus the needle had to be removed using ECC and fluoroscopy.