University of Louisville, Department of Surgery, Louisville, KY 40292, United States.
Injury. 2011 May;42(5):441-6. doi: 10.1016/j.injury.2010.08.006.
Bullet emboli are an infrequent and unique complication of penetrating trauma. Complications of venous and arterial bullet emboli can be devastating and commonly include limb-threatening ischaemia,pulmonary embolism, cardiac valvular incompetence, and cerebrovascular accidents. Bullets from penetrating wounds can gain access to the venous circulation and embolise to nearly every large vascular bed. Venous emboli are often occult phenomenon and may remain unrecognised until migration leads to vascular injury or flow obstruction with resultant oedema. The majority of arterial emboli present early with end-organ or limb ischaemia. We describe four separate cases involving venous bullet embolism and the subsequent management of each case. Review of the literature focusing on the reported management of these injuries, comparison of techniques of management, as well as the evolving role of endovascular techniques in the management of bullet emboli is provided.
弹丸栓塞是穿透性创伤的一种罕见且独特的并发症。静脉和动脉弹丸栓塞的并发症可能是毁灭性的，通常包括危及肢体的缺血、肺栓塞、心瓣膜功能不全和脑血管意外。穿透性伤口的子弹可以进入静脉循环并栓塞到几乎所有大的血管床。静脉栓塞通常是隐匿性的，直到迁移导致血管损伤或血流阻塞引起水肿，否则可能不会被识别。大多数动脉栓塞早期表现为终末器官或肢体缺血。我们描述了 4 例涉及静脉弹丸栓塞的病例，以及每例病例的后续处理。我们回顾了文献，重点介绍了这些损伤的报告处理方法，比较了处理技术，以及血管内技术在弹丸栓塞处理中的不断发展作用。
