Repetitive Sharps Ingestion and Challenges with Retrieval and Prevention.

INTRODUCTION: Recurrent deliberate sharp foreign body ingestion is associated with frequent hospitalizations and a high risk of complications, including perforation and peritonitis. These patients require urgent care. In addition, removal of foreign bodies can be challenging. CASE DESCRIPTION: We describe the case of a patient with borderline personality disorder who was admitted multiple times with sharps ingestion and presented challenges with her care. CONCLUSION: Our case highlights the cause of recurrent sharps ingestion and provides recommendations on the retrieval of sharp foreign bodies and prevention. LEARNING POINTS: Recurrent sharps ingestion is associated with psychiatric illness.Ingested sharps can cause perforation and peritonitis, so urgent care is required.A multidisciplinary approach is necessary to care for these patients and prevent sharps ingestion in future.

Postoperative Outcome in Patients with Pulmonary Hypertension Undergoing Elective Non-Cardiac Surgery.

INTRODUCTION: The impact of pulmonary artery hypertension on post-operative outcome in elective, non-cardiac surgery is incompletely understood. This study was designed to evaluate the post-operative outcome of patients undergoing elective, non-cardiac surgery with and without pulmonary hypertension. METHODS: The study was conducted in an inner-city hospital in Bronx, New York. A retrospective chart review was conducted on all patients who underwent elective, non- cardiac surgery from January 2000 to December 2010 and had echocardiogram within 30 days of surgery. Patients with systolic pressure of ≥35mm of Hg as estimated by echocardiogram were enrolled. Case matched peers with normal pulmonary pressures served as controls. Post-operative outcomes were compared between the two groups. RESULTS: A total of 66 patients were analysed, 33 cases and 33 controls. All patients were followed up to 30-day post-surgery. Heart failure, myocardial infarction, arrhythmia, stroke, delayed extubation and deaths were measured in both the groups. There were two deaths in the control group while there were three deaths in pulmonary hypertension group (statistically not significant, P >0.05). A total of three patients in pulmonary hypertension group had adverse outcome (one had a major arrhythmia, one had delayed extubation (>24 hours) and one had stroke). Whereas two patients in control group had adverse outcome (one had delayed extubation (>24 hours) and one had major arrhythmia). CONCLUSIONS: Pulmonary hypertension does not affect the post-operative outcome in the first 30 days for elective non-cardiac surgery.