García-Lledó J A, Moya Mur J L, Balaguer Recena J, Novo García E, Sancho Piedras J M, Sáiz Beneit R, Rubio Cantarero C, Epeldegui Torre A, Oliva de Anquín E
Sección de Cardiología, Hospital Universitario de Guadalajara.
Rev Esp Cardiol. 1997 Feb;50(2):137-9. doi: 10.1016/s0300-8932(97)73193-2.
We present the case of a patient who suffered a cardiac penetrating trauma due to a 6-cm long steel splinter. He was self-admitted to the emergency room and was asymptomatic. Cardiac trauma was diagnosed by the presence of a foreign body in his chest X-ray. Transthoracic and transesophageal echocardiography showed pericardial effusion and a dense foreign body that crossed the left ventricle from upside down and forward to back. The patient underwent cardiac surgery under extracorporal circulation. A shooting wound was seen on the left ventricular free wall. Transesophageal echocardiography was performed during surgery in order to define the position of the foreign body and to discard lesions due to multidirectional injury. Lesions were repaired and the patient was discharged with no complications. This case report illustrates the possibility of survival after cardiac penetrating trauma, and the role of echocardiography in the diagnosis and surgical repair of this type of trauma.
我们报告一例因一根6厘米长的钢碎片导致心脏穿透伤的患者。他自行前往急诊室，当时无症状。胸部X线检查发现体内有异物，从而诊断出心脏创伤。经胸和经食管超声心动图显示心包积液以及一个致密异物，该异物从上方经左心室由前向后穿过。患者在体外循环下接受了心脏手术。在左心室游离壁可见一处枪伤。手术期间进行了经食管超声心动图检查，以确定异物位置并排除多方向损伤所致的病变。对病变进行了修复，患者出院时无并发症。本病例报告说明了心脏穿透伤后存活的可能性，以及超声心动图在这类创伤的诊断和手术修复中的作用。
