静脉子弹栓塞及随后的血管内取出术——一例病例报告及文献综述
Venous bullet embolism and subsequent endovascular retrieval - A case report and review of the literature.
作者信息
Carter Cullen O, Havens Joaquim M, Robinson William P, Menard Matthew T, Gates Jonathan D
机构信息
Brigham and Women's Hospital, Department of Surgery, 75 Francis St., Boston, MA 02215, United States.
出版信息
Int J Surg Case Rep. 2012;3(12):581-3. doi: 10.1016/j.ijscr.2012.06.011. Epub 2012 Aug 21.
INTRODUCTION
Vascular bullet embolism is a rare phenomenon with fewer than 200 cases reported in the literature.
PRESENTATION OF CASE
A 22 year-old male presented with a gunshot wound to the right lower quadrant. Imaging demonstrated a bullet lodged in his left lower quadrant. Upon operative exploration, a single hole was found in the right external iliac vein without injury into the left lower quadrant. The bullet was found to have migrated intravascularly from the right external to the left common iliac vein, and was subsequently removed endovascularly.
DISCUSSION
Bullet embolism occurs infrequently, with arterial more common than venous. Arterial embolization usually requires emergency operative intervention due to ischemia. While venous embolization is often asymptomatic, removal of the bullet is recommended to avoid delayed complications when possible.
CONCLUSION
Venous bullet emboli should be removed endovascularly whenever technically possible.
引言
血管内子弹栓塞是一种罕见现象，文献报道的病例不足200例。
病例介绍
一名22岁男性因右下腹枪伤就诊。影像学检查显示子弹嵌顿在左下腹。手术探查时，发现右髂外静脉有一个单孔，未伤及左下腹。发现子弹经血管从右髂外静脉迁移至左髂总静脉，随后通过血管内方式取出。
讨论
子弹栓塞很少见，动脉栓塞比静脉栓塞更常见。由于缺血，动脉栓塞通常需要紧急手术干预。虽然静脉栓塞通常无症状，但建议尽可能取出子弹以避免延迟并发症。
结论
只要技术可行，静脉子弹栓子应通过血管内方式取出。
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