SynthesisAddiction (Abingdon, England)2026
Tissue-retained needles in people who inject drugs: A systematic review of case reports and series on clinical presentations, complications and management.
Synthesis in Addiction (Abingdon, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Tissue-retained needles in people who inject drugs: A systematic review of case reports and series on clinical presentations, complications and management.Addiction (Abingdon, England) · 2026Pooled it
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsTissue-retained needles from intravenous drug use can cause rare but severe complications, ranging from local to systemic infections to needle embolization. Due to the limited evidence and the lack of epidemiological studies on the issue, we systematically reviewed the literature focusing on case reports and case series on the clinical presentations, diagnostic approaches, and management of tissue-retained needle fragments.
methodsA systematic review of English-language case reports and case series was conducted (PROSPERO ID: CRD42024517020) on 15 November 2024, using PubMed and Scopus. Two authors performed the search independently and in duplicate following the PRISMA flow diagram. Case reports were included when the retained needles among people who inject drugs were confirmed by imaging, surgery or autopsy. Data on clinical characteristics, presentation, complications and outcomes were extracted by two reviewers and summarized descriptively.
resultsFrom 1479 citations, we included 46 publications reporting 52 cases [47 (90%) patients and 5 (9.6%) autopsy cases]. Patients were mostly young adults with a median age of 35.0 (range: 22-55) years and predominantly male [n = 37/52 (71%)]. No deaths were reported among the patients presenting with needle fragments; in the autopsy cases, the needles were incidental findings and not the cause of death. Although injection sites were not systematically imaged in all cases, nearly one third [n = 15/52 (29%)] of cases involved multiple retained needles. Needles migrated via circulation were most often found in the heart [n = 23/52 (44%)] or the lungs [n = 13/52 (25%)]. One fifth [10/47 (21%)] of the patients received antibiotics without needle retrieval, and in 18/47 patients (38%) the needle was surgically removed.
conclusionsRetained needle fragments among people who inject drugs are found in a range of anatomical sites, are often multiple, are not associated with fatal outcomes and are often incidental findings in autopsies. Management varies substantially as some patients receive antibiotics alone while some have needles removed surgically.
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