An intracardiac foreign body: diagnosed non-invasively and removed non-surgically

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Abstract
The hazards of retained catheter fragments are significant and in a recent review of the literature 16 well-documented fatalities were reported (Fisher and Ferreyro, 1978). In 12 of these 16 cases, catheter fragments were lodged in either the right atrium, the right ventricle, or both. Five patients died because of perforation of the heart; four from sepsis; three from pulmonary emboli; two from cardiac arrests secondary to arrhythmias, one from monilial endocarditis, and one from a perforated heart valve. The latter patient was also found to have a mycotic aneurysm of the pulmonary artery. Fisher and Ferreyro calculated the overall potential risk of death or serious complications from retained catheter fragments to be 71%. They emphasized that although patients may remain well initially, catastrophes can occur several months or even years after embolization. A 27-year-old male Ghanaian was transferred from Accra to the Hammersmith Hospital with an 11-day history of abdominal pain followed by constipation, fever, dehydration and jaundice. On admission he was confused, pyrexial and jaundiced. His abdomen was distended and painful with ascites and massive hepatomegaly. Abdominal ultrasonography suggested the presence of five large cystic lesions in the liver, and hepatic angiography showed displacement of vessels around these lesions with no evidence of a tumour circulation. Percutaneous needle aspiration of one of these lesions yielded fluid containing large numbers of Entamoeba histolytica.