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胸部枪伤患者大量空气栓塞的CT表现:一份特殊病例报告,宛如进行了全身肺血管造影。

CT Findings of the Massive Air Embolism in a Case with Thoracic Gunshot Wound: A Special Case Report as if a Whole Body Pneumo- Angiography was Performed.

作者信息

Zeynalova Amalya, Sanli Deniz E T, Agar Emir H, Yildirim Duzgun, Tuzuner Filiz

机构信息

Department of Radiology, Acibadem Taksim Hastanesi Institute, Istanbul, Turkey.

Department of Emergency, Acibadem Taksim Hastanesi Institute, Istanbul, Turkey.

出版信息

Curr Med Imaging. 2022;18(11):1253-1256. doi: 10.2174/0929866529666220426121222.

Abstract

BACKGROUND

Massive Systemic Arterial Air Embolism (SAAE) associated with penetrating trauma is a rare condition. A few cases were reported for massive arterial air embolism in the literature. Computed tomography is a fast and easily accessible modality for detecting air in the vasculature. We report CT findings of a rare case with a thoracic gunshot wound, which demonstrate air almost in all systemic vessels like ''full body pneumoangiography''.

CASE PRESENTATION

A 42-year-old male patient with a thoracic gunshot wound was admitted to the Accident and Emergency (A&E) unit in a state of cardiac arrest. Postmortem Computed Tomography (CT) was performed and extensive air was revealed in several great vessels.

CONCLUSION

We conclude that the underline causes of massive air embolism in our case are two main mechanisms: firstly, massive air enters the vasculature via bronchovascular fistula as there was bilateral lung contusion and directly through cardiac truncus, secondly while CPR was being conducted, massive air was pumped to the systemic circulation.

摘要

背景

与穿透性创伤相关的大量系统性动脉空气栓塞(SAAE)是一种罕见的病症。文献中报道了少数几例大量动脉空气栓塞的病例。计算机断层扫描是一种快速且易于获取的用于检测血管系统中空气的检查方式。我们报告了一例罕见的胸部枪伤病例的CT表现,其显示几乎所有全身血管内都有空气,就像“全身肺血管造影”一样。

病例介绍

一名42岁胸部枪伤男性患者在心脏骤停状态下被送入急诊室。进行了尸检计算机断层扫描(CT),结果显示在几条大血管中有大量空气。

结论

我们得出结论,本例中大量空气栓塞的潜在原因有两个主要机制:首先,由于双侧肺挫伤,大量空气通过支气管血管瘘并直接通过心脏干进入血管系统;其次,在进行心肺复苏时,大量空气被泵入体循环。

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