The rationale:
A 19-year-old female presented to the Otorhinolaryngology Department.
Patient concerns:
Pain over the right side of the neck below the angle of the mandible following a fall on a pin cushion after a fight with her brother. She reported that the wound might have been caused by a sewing needle lodged in the pin cushion.
Diagnosis:
X-ray soft-tissue neck lateral view revealed a radiopaque linear shadow on the right side of the neck at the level of the C1-C2 vertebrae. On contrast-enhanced computed tomography, a linear (needle-like) foreign body at the level of C1-C2 was approximately 1.6 cm deep from the skin. The internal jugular vein seemed to be compressed between the needle and vertebrae.
Treatment:
Foreign body was explored and removed under general anaesthesia by an open lateral cervical approach.
Outcomes:
The patient's postoperative recovery was uneventful.
Take-away lesson:
Due to early diagnosis, management, and a team of experienced surgeons, anaesthesiologists, and support staff, any morbidity or mortality was avoided.