Reiss M, Pilling E
Klinik für Hals-Nasen-Ohrenheilkunde, des Universitätsklinikums Dresden.
Laryngorhinootologie. 1996 Jul;75(7):426-32. doi: 10.1055/s-2007-997608.
Bullet wounds are a rare occurrence during times of peace. Recently, however, there has been a general increase in the relative number and severity of this type of trauma. In times of peace, gunshot wounds may be mainly caused by suicide attempts, negligent handling of firearms and especially violent conflicts. Bullet wounds, in contrast to wounds caused by a blow or impact to the viscerocranium, are characterised by an irregular path, entry and exit wounds, as well as localised demolition of bones with the associated defects.
30 patients with gunshot wounds were treated during the past 35 years. Basing on four case reports, problems of interdisciplinary treatment approach to gunshot wounds are discussed, as well as the diagnostic and therapeutic consequences.
The first case concerns a retained missile in the left fossa pterygopalatina. Intraoperative removal caused a rupture of the A. maxillaris. Preoperative angiography could have provided valuable information. In the second case, an injury caused by a shot from a blank cartridge pistol in the left facial area resulted in extensive wounds with several surgical revisions. The third case was a shot injury to the tongue with an unexpected wound and bleeding. The fourth case describes a child with a bullet in a hyperplastic adenoid tonsil. Primary careful treatment is of greatest significance for functional and cosmetic results due to extensive rupturing and wounds.
在和平时期，枪伤较为罕见。然而，近年来，此类创伤的相对数量和严重程度总体呈上升趋势。在和平时期，枪伤主要可能由自杀未遂、枪支的疏忽处理，尤其是暴力冲突导致。与因打击或撞击面颅骨造成的伤口不同，枪伤的特点是路径不规则、有出入口伤口，以及伴有相关缺损的局部骨破坏。
在过去35年中，共治疗了30例枪伤患者。基于4例病例报告，讨论了枪伤跨学科治疗方法的问题，以及诊断和治疗结果。
第一例涉及一枚留在翼腭窝的子弹。术中取出导致上颌动脉破裂。术前血管造影本可提供有价值的信息。第二例，一枚空包弹手枪射出的子弹造成左面部受伤，导致多处伤口并进行了多次手术修复。第三例是舌部枪伤，伴有意外伤口和出血。第四例描述了一名儿童，其增生的腺样体扁桃体中有一颗子弹。由于广泛的破裂和伤口，早期谨慎治疗对功能和美容效果至关重要。
