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动能冲击豆袋弹丸所致穿透性胸部损伤的微创外科治疗

Minimally invasive surgical management of penetrating chest injury from kinetic impact bean bag projectile.

作者信息

Marrufo Angelica S, Boyd W Douglas, Leshikar David E

机构信息

UC Davis School of Medicine, Sacramento, CA, United States of America.

Division of Cardiothoracic Surgery, UC Davis Health, Sacramento, CA, United States of America.

出版信息

Trauma Case Rep. 2019 Jun 28;22:100210. doi: 10.1016/j.tcr.2019.100210. eCollection 2019 Aug.

Abstract

Bean bag guns are considered "non-lethal" weapons used by law enforcement. There are emerging reports in the medical literature on management of penetrating, intrathoracic injuries and none were found that involve potential cardiac complications. We present a case of a penetrating bean bag involving the pericardium. A young, adult man was shot in the left axillary region by law enforcement and presented hemodynamically stable. Computed Tomography (CT) demonstrated a bean bag anterolateral to the pericardium, associated with a small pulmonary contusion and hemopneumothorax. He underwent a left tube thoracostomy and sub-xiphoid pericardial window with cardiopulmonary bypass on standby. The diagnostic pericardial window showed no pericardial effusion and the foreign body extraction was successfully performed through the subxiphoid incision via Video Assisted Thoracoscopic Surgery. There were no intra-operative or post-operative complications.

摘要

豆袋枪被视为执法部门使用的“非致命”武器。医学文献中出现了关于穿透性胸内损伤处理的报道,但未发现涉及潜在心脏并发症的情况。我们报告一例累及心包的穿透性豆袋枪伤病例。一名年轻成年男性被执法人员射中左腋窝区域,就诊时血流动力学稳定。计算机断层扫描(CT)显示心包前外侧有一个豆袋,伴有小面积肺挫伤和血气胸。他接受了左胸腔闭式引流术和剑突下心包开窗术,体外循环待命。诊断性心包开窗术显示无心包积液,通过剑突下切口经电视辅助胸腔镜手术成功取出异物。术中及术后均无并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/607a/6610230/3798f15494ab/gr1.jpg

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