Barasa Jack, Nthumba Peter M, Bird Peter
Plastic Reconstructive and Hand Unit, Department of Surgery, AIC Kijabe Hospital, Kenya.
Ear Nose Throat J. 2013 Aug;92(8):E12. doi: 10.1177/014556131309200820.
Penetrating tracheal injuries are rare. Even rarer is the finding of intrabronchial foreign bodies caused by penetrating objects. We report a patient who experienced a gunshot injury to the trachea and mandible. The tracheal wound was debrided and used as a tracheostomy; a spent bullet in the bronchial tree was missed on initial evaluation but later successfully retrieved bronchoscopically. Spent bullet aspiration is a very rare occurrence. A careful examination of radiographs is essential to aid with the diagnosis. Flexible bronchoscopy is the best means of bullet retrieval. Management of any associated injuries is made easier after the airway is secured.
穿透性气管损伤较为罕见。由穿透性物体导致支气管内异物的情况则更为罕见。我们报告一名患者，其气管和下颌骨遭受枪伤。气管伤口进行了清创处理并用作气管造口术；最初评估时遗漏了支气管树内的一枚哑弹，但后来通过支气管镜检查成功取出。取出哑弹极为罕见。仔细检查X光片对于辅助诊断至关重要。可弯曲支气管镜检查是取出子弹的最佳方法。确保气道安全后，处理任何相关损伤会更容易。
