Calışkan Müjgan, Evren Ismail, Kabak Ismail, Atak Ibrahim, Gökcan Recai
Department of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
Ulus Travma Acil Cerrahi Derg. 2011 Sep;17(5):455-7. doi: 10.5505/tjtes.2011.67934.
We report a case with gunshot to the pelvis. The injury site was the soft tissue between the rectum and urinary bladder. Several days later, the bullet was expulsed spontaneously during voiding. In the literature, only a few case reports have described spontaneous expulsion of an intravesical bullet. A 19-year-old male was wounded on the left hip by gunshot. Radiographic examinations showed a bullet in the pelvis, which was localized in the soft tissue between the rectum and urinary bladder, with no accompanying visceral injury on abdominopelvic computerized tomography. Macroscopic hematuria was noticed after urethral catheterization. Rectosigmoidoscopy and retrograde cystoscopic examinations were both negative. The patient was monitored closely and treated conservatively with no surgical intervention. The urinary catheter was removed on the fifth postoperative day, and the bullet was expulsed spontaneously via the urethra during normal voiding three hours after catheter removal. Thereafter, a retrograde urethrography was performed, which showed no evidence of urinary tract or bladder injury.
我们报告一例骨盆枪伤病例。损伤部位是直肠与膀胱之间的软组织。数日后，子弹在排尿时自行排出。在文献中，仅有少数病例报告描述过膀胱内子弹的自行排出。一名19岁男性左髋部受枪伤。影像学检查显示骨盆内有一枚子弹，位于直肠与膀胱之间的软组织内，腹部盆腔计算机断层扫描未发现伴有内脏损伤。尿道插管后出现肉眼血尿。直肠乙状结肠镜检查和逆行膀胱镜检查均为阴性。对患者进行密切监测并采取保守治疗，未进行手术干预。术后第5天拔除导尿管，拔除导尿管3小时后，子弹在正常排尿时经尿道自行排出。此后，进行了逆行尿道造影，结果显示没有尿路或膀胱损伤的迹象。
