Multiple self-inserted pins and nails in pericardium in a patient of schizophrenia: Case report and review

Abstract

This report is the case of multiple self-inserted pins and nails in chest and pericardial cavity in a young male suffering from schizophrenia. This act of self-mutilation was done to get relief from burning sensation in chest and palpitations. Review of the relevant literature revealed that self-inflicted intra-cardiac needle injuries occur mainly in young and middle-aged adults suffering from psychiatric disorders, commonly depression, schizophrenia, and substance use disorders. In one-fourth of the patients, it is due to deliberate self-harm. About 70% use a single needle but 30% may use multiple needles. Second attempts are rare. Majority of the patients (85%) are managed by surgery and recover from the injury. The condition has a low mortality rate of 5%.

Keywords

• Major self mutilation
• pain insensitivity
• pericardial cavity
• schizophrenia