Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA.
Am Surg. 2023 Aug;89(8):3614-3615. doi: 10.1177/00031348231167413. Epub 2023 Mar 24.
Gunshot wounds account for significant morbidity and mortality in the United States. A rare and potentially fatal complication of a gunshot wound is bullet embolus. Potential complications include distal limb ischemia, coronary infarct, renal infarction, stroke, pulmonary embolization, cardiac valvular injury, thrombophlebitis, and dysrhythmias. Overall, surgical embolectomy and endovascular retrieval are the preferred treatments for bullet emboli. We report one case of venous bullet embolus and one case of arterial bullet embolus, both of which were successfully treated with endovascular retrieval. A thorough physical exam and appropriate imaging are vital to prompt identification and treatment of bullet emboli, as the repercussions of missed injuries can be devastating.
在美国,枪伤会导致严重的发病率和死亡率。枪伤的一种罕见且可能致命的并发症是子弹栓子。潜在的并发症包括远端肢体缺血、冠状动脉梗死、肾梗死、中风、肺栓塞、心脏瓣膜损伤、血栓性静脉炎和心律失常。总的来说,手术取栓和血管内取栓是治疗子弹栓子的首选方法。我们报告了一例静脉子弹栓子和一例动脉子弹栓子,这两例均通过血管内取栓成功治疗。彻底的体格检查和适当的影像学检查对于及时识别和治疗子弹栓子至关重要,因为错过这些损伤的后果可能是毁灭性的。