Graham J M, Mattox K L
J Thorac Cardiovasc Surg. 1981 Aug;82(2):310-3.
Victims of gunshot wounds may be noted to have bullets overlying the cardiac silhouette on roentgenogram. Direct cardiac penetration, bullet embolus to the heart, and missile proximity to the heart are all possibilities which must be differentiated. An unusual case of bullet embolism is presented in which thoracotomy was initially performed to rule out direct cardiac penetration. At the time of exploration, an intracardiac bullet embolus was fortuitously palpated and trapped within the apex of the right ventricle. Right ventriculotomy and embolectomy without cardiopulmonary bypass were performed to prevent retrograde or distal migration.
枪伤受害者在X线片上可能显示子弹位于心脏轮廓上方。直接心脏穿透伤、子弹栓子进入心脏以及子弹靠近心脏都是需要鉴别的可能情况。本文介绍了一例不寻常的子弹栓塞病例，最初进行开胸手术以排除直接心脏穿透伤。在探查时，偶然摸到一枚心内子弹栓子并将其卡在右心室心尖部。在未进行体外循环的情况下进行了右心室切开取栓术，以防止栓子逆行或远端迁移。
