Siegel Rebecca, Sarani Babak, Meltzer Andrew C
The George Washington University School of Medicine and Health Sciences, Department of Emergency Medicine, Washington, DC, USA.
The George Washington University School of Medicine and Health Sciences, Department of Surgery and Emergency Medicine, Washington, DC, USA.
Trauma Case Rep. 2019 Dec 18;25:100272. doi: 10.1016/j.tcr.2019.100272. eCollection 2020 Feb.
The rapid delivery of care for penetrating traumatic injury, such as gunshot wounds, is essential to minimizing the morbidity and mortality rate. It is highly unusual for a patient who has sustained a firearm injury to present over 24 h after the event and even more unusual for the patient to be amnestic to the event. We report a case of a 44-year old woman who presented to the Emergency Department (ED) with an abdominal firearm injury sustained over 24 h earlier. The patient had no recollection of the events surrounding this injury. An abdominal Computed Tomography (CT) scan confirmed an intra-abdominal injury consistent with ballistic trauma. Upon further questioning, the patient continued to deny having sustained a gunshot but did reveal that she smoked phencyclidine (PCP) one day earlier with her boyfriend. The patient was admitted for emergency laparotomy and bowel resection and had a prolonged hospital course due to development of necrotizing soft tissue infection of the abdominal wall and an enterocutaneous fistula. This case represents an unusual delayed presentation of ballistic trauma after recreational consumption of PCP.
对于穿透性创伤，如枪伤，迅速提供治疗对于降低发病率和死亡率至关重要。遭受火器伤的患者在事件发生后24小时以上就诊是非常罕见的，而患者对该事件失忆则更为罕见。我们报告一例44岁女性患者，她在事件发生24小时多后因腹部火器伤就诊于急诊科。患者对围绕此次受伤的事件没有记忆。腹部计算机断层扫描（CT）证实存在与弹道创伤相符的腹腔内损伤。进一步询问时，患者继续否认遭受枪伤，但确实透露她一天前与男友吸食了苯环己哌啶（PCP）。患者因紧急剖腹手术和肠切除入院，由于腹壁坏死性软组织感染和肠皮肤瘘的发生，住院时间延长。该病例代表了娱乐性吸食PCP后弹道创伤的异常延迟表现。
