Vedelago John, Dick Elizabeth, Thomas Robert, Jones Brynmor, Kirmi Olga, Becker Jennifer, Alavi Afshin, Gedroyc Wladyslaw
Radiology Department, St. Mary's Hospital, Praed Street, London, W2 1NY United Kingdom.
J Trauma Manag Outcomes. 2014 Nov 15;8:19. doi: 10.1186/1752-2897-8-19. eCollection 2014.
We describe two cases of intravascular embolization of shotgun pellets found distant to the entry site of penetrating firearm injury. The cases demonstrate antegrade embolization of a shotgun pellet from neck to right middle cerebral artery, and antegrade followed by retrograde venous embolization through the left lower limb to pelvis. Radiologists and Trauma Physicians should be aware that post shotgun injury, the likelihood of an embolised shot pellet is increased compared to other types of firearm missile injury, and should therefore search away from the site of injury to find such missiles. Shotgun pellets may travel in an antegrade or a retrograde intravascular direction - both were seen in these cases - and may not be clinically obvious. This underscores the importance of a meticuluous search through all images, including CT scout images, for evidence of their presence.
我们描述了两例在穿透性火器伤入口部位远处发现霰弹枪子弹血管内栓塞的病例。这些病例展示了一枚霰弹枪子弹从颈部顺行栓塞至右侧大脑中动脉，以及一枚子弹先顺行，随后经左下肢逆行至骨盆静脉的栓塞情况。放射科医生和创伤科医生应意识到，与其他类型的火器导弹伤相比，霰弹枪伤后子弹发生栓塞的可能性增加，因此应在远离损伤部位处寻找此类子弹。霰弹枪子弹可能会顺行或逆行于血管内——在这些病例中均有发现——且在临床上可能并不明显。这凸显了仔细查看所有影像（包括CT定位像）以寻找其存在证据的重要性。
