Porcupine quills or not?

Do you see porcupine quills? What would you do next?
Please send your comments!

This entry was posted by Dominique.

12 thoughts on “Porcupine quills or not?

  1. Hello Dominique! (We met in Italy in June and sat on the steps of the Greek theater together!) I see multiple quills in the shoulder musculature. Double hyperechoic lines with a hypoehoic core – some with an ill-defined hypoechoic halo around them. Ultrasound-guided removal could be attempted but may be difficult to get them all. I would be more concerned with the pneumothorax at this time as quill migration into the lung and chest cavity is highly likely. Thoracocentesis of the air first of course and ultrasound of the lung could be attempted but may be difficult due the the air (can’t see through gas) CT could be performed but I understand it does not always pick up quills. Ultimately thoracotomy and explore of the thoracic cavity and lungs would be warranted. Palpation of the lungs or intra-op ultrasound could be used to look for quills and guide their removal.

  2. se observan múltiples espinas de puercoespín. Como paso siguiente realizaría una ecografía torácica. Luego la extracción quirúrgica de las espinas.

    • Not sure I fully understand the reply…but I think you recommend an ultrasound evaluation of the thorax, after seeing numerous quills in the shoulder. Also, you recommend an exploratory surgery to remove the quills.
      I’ll post my comments on Monday, to get a chance to hear more opinions. Thank you!

      • yes, because the patient had possible pneumothorax due to the porcupine’s quills, I would perform an ultrasound examination of the thorax, and then I would remove the quills from the shoulder. Best regards

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