Muñoz Carlos Andres, Quitian Jairo González, García Alberto, Ordoñez Carlos Alberto, Buchelli Víctor Rafael
Department of Trauma and Emergency Surgery, Hospital Universitario del Valle - Fundación Valle del Lili, Cali, Colombia.
Department of General Surgery, Universidad del Valle, Hospital Universitario del Valle, Cali, Colombia.
Trauma Case Rep. 2021 Apr 22;33:100489. doi: 10.1016/j.tcr.2021.100489. eCollection 2021 Jun.
The presence of foreign bodies (FB) retained in the heart or pericardium secondary to penetrating trauma in stable patients is a very rare event and its management is controversial. We present the case of a 19-year-old patient who was admitted to our trauma center hemodynamically stable because of two gunshot wounds in the lumbar region. A chest x-ray (CXR) revealed a blurred foreign body over the right heart chamber, thoracoabdominal computed tomography (CT) scan showed a free projectile over the left atrial wall, and transesophageal echocardiogram (TEE) showed a hyperrefringent pericardial sac image near the right ventricle. Finally, the patient went to surgery where a missile was removed from the pericardial sac by video-assisted thoracoscopic surgery (VATS).
稳定患者因穿透性创伤导致异物（FB）留存于心脏或心包内是极为罕见的情况，其处理存在争议。我们报告一例19岁患者，因腰部两处枪伤被送至我院创伤中心，血流动力学稳定。胸部X线（CXR）显示右心腔上方有一模糊异物，胸腹计算机断层扫描（CT）显示左心房壁上方有一游离弹丸，经食管超声心动图（TEE）显示右心室附近有心包囊高回声图像。最终，患者接受手术，通过电视辅助胸腔镜手术（VATS）从心包囊中取出一枚导弹。
