Fiorica V, Brinker J E
J Okla State Med Assoc. 1989 Feb;82(2):63-7.
A young man was found to have elevated blood lead and erythrocyte protoporphyrin levels seven years after he had been shot in the foot with a .22 caliber bullet. Although clearly evident in radiographs obtained at the time of the accident, the bullet had never been removed. Over the course of the intervening years the radiographic appearance of the projectile changed dramatically. The patient underwent a surgical debridement procedure with some resolution of his lead intoxication. This case was reviewed in the context of the literature describing the disposition of retained lead projectiles. Lead bullets or fragments lodged within joints are slowly disintegrated and, as absorption accelerates, predispose the patient to the risk of lead poisoning which may occur many years after the original incident. Prompt removal of any lead projectile entering a joint space is strongly recommended.
一名年轻男子在足部被.22口径子弹击中七年后，被发现血铅和红细胞原卟啉水平升高。尽管在事故发生时的X光片上子弹清晰可见，但一直未取出。在随后的几年里，子弹的X光影像发生了显著变化。患者接受了外科清创手术，铅中毒症状有所缓解。结合描述滞留铅弹处理情况的文献对该病例进行了回顾。滞留在关节内的铅弹或碎片会慢慢分解，随着吸收加速，使患者易患铅中毒风险，这种情况可能在最初事件发生多年后出现。强烈建议及时取出任何进入关节腔的铅弹。
