Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Department of Emergency, Chi-Mei Medical Center, Tainan-Taiwan.
Ulus Travma Acil Cerrahi Derg. 2021 Nov;27(6):702-705. doi: 10.14744/tjtes.2020.12686.
Emergency physicians may overlook spinal cord injury in patients when the direct impact of a gunshot on the spine is lacking. A 30-year-old man who was shot on his right chest wall was brought to the emergency department. He arrived in a state of shock and underwent emergent thoracotomy for massive hemothorax. After surgery, he was found to be paraplegic. Magnetic resonance imaging of the spine showed T4 spinal cord contusion. The penetrating bullet dissipates energy to the surrounding tissue and contuses the spinal cord. Another assumption of the spinal cord injury is the impairment of blood supply to the cord. No effective treatment exists for gunshot-related indirect injury to the spinal cord. These reported cases reminded emergency physicians that after stabilization of the patient with a gunshot wound, a complete neurologic examination should be performed to discover occult spinal cord injury.
急诊医师可能会忽视脊髓损伤的患者时，直接的影响，枪击对脊柱是缺乏的。一名 30 岁的男子谁被枪杀在他的右胸壁被带到急诊室。他到达休克状态，并接受紧急开胸术治疗大量血胸。手术后，他被发现截瘫。脊柱磁共振成像显示 T4 脊髓挫伤。穿透性子弹消散能量对周围组织和挫伤脊髓。另一个假设的脊髓损伤是损害血液供应的脊髓。没有有效的治疗存在与枪击有关的间接损伤脊髓。这些报道的病例提醒急诊医师，在稳定的病人与枪伤后，应进行完整的神经系统检查，以发现隐匿性脊髓损伤。
