Nagy K K, Massad M, Fildes J, Reyes H
Department of Trauma, Cook County Hospital, Chicago, Illinois 60612.
Am Surg. 1994 Dec;60(12):975-9.
Embolization of missiles is an unusual presentation of penetrating trauma. Often the management of these injuries may be quite challenging, and selective management continues to be subject to controversy. We report a case of a bullet embolus to the right ventricle from the internal iliac vein in a 15-year-old boy that was managed with observation. An algorithm for diagnosis and management of this phenomenon mandates exploration of emboli to the aorta and peripheral arteries with repair of the vascular entry site and embolectomy. It also recommends operative intervention for symptomatic venous emboli to the heart and pulmonary circulation. Nonoperative management may be considered in patients with asymptomatic emboli to the right heart or the cerebral and pulmonary circulation.
导弹栓塞是穿透性创伤的一种罕见表现。这些损伤的处理往往颇具挑战性，且选择性处理仍存在争议。我们报告一例15岁男孩因髂内静脉子弹栓子进入右心室的病例，该病例通过观察进行处理。针对这种现象的诊断和处理算法要求探查主动脉和外周动脉的栓子，并修复血管入口部位及进行栓子切除术。它还建议对有症状的心脏和肺循环静脉栓子进行手术干预。对于右心或脑循环及肺循环无症状栓子的患者，可考虑非手术治疗。
