Mattox K L, Beall A C, Ennix C L, DeBakey M E
Am J Surg. 1979 Feb;137(2):192-5. doi: 10.1016/0002-9610(79)90143-0.
The estimated course of a penetrating missile provides some clues to planning intraoperative priorities and management. However, missiles which become intravascular emboli present diagnostic and therapeutic dilemmas. Twenty-eight patients have been seen with bullet emboli. Five patients had emboli to the lungs, two of which were removed. Two large bullets embolized from a right heart injury down the inferior vena cava, one to a hepatic vein and one to the right renal vein. Fourteen patients had arterial bullet emboli, four originating in the heart, four in the thoracic aorta, and six in the abdominal aorta. Two patients died, one of cerebral infarction secondary to bullet embolus to the right carotid artery and one of an unrecognized traumatic intracardiac defect. Complications were secondary to associated injuries rather than a result of removal of bullet emboli.
穿透性导弹的预估行径为术中优先事项的规划和管理提供了一些线索。然而，成为血管内栓子的导弹会带来诊断和治疗上的难题。已接诊28例子弹栓子患者。5例肺部有栓子，其中2例栓子被取出。2枚大子弹从右心损伤处沿下腔静脉栓塞，1枚栓塞至肝静脉，1枚栓塞至右肾静脉。14例患者有动脉子弹栓子，4例起源于心脏，4例起源于胸主动脉，6例起源于腹主动脉。2例患者死亡，1例因右颈动脉子弹栓子继发脑梗死死亡，1例因未被识别的创伤性心内缺损死亡。并发症是由相关损伤引起的，而非子弹栓子取出的结果。
