RESUMO
Penetrating cardiac injury (PCI) secondary to a gunshot wound presents with several complications and a mortality rate of 94% before reaching the hospital. Current literature search reveals that embolism of bullet fragments after gunshot wounds are exceptionally rare. Additionally, no reported case was found regarding bullet embolism following left atrium penetration at the time of this case report. This case describes a 34-year-old male who presented to a level I trauma center after sustaining a gunshot wound to the posterior torso. Imaging demonstrated several fragments in the mid-thoracic region in addition to the primary bullet fragment located within the aorta at the bifurcation of the iliac arteries likely due to left atrial penetration and subsequent embolization.
Assuntos
Aorta Abdominal , Migração de Corpo Estranho/etiologia , Traumatismos Cardíacos/etiologia , Ferimentos por Arma de Fogo/complicações , Adulto , Aorta Abdominal/diagnóstico por imagem , Aorta Abdominal/cirurgia , Aortografia , Angiografia por Tomografia Computadorizada , Migração de Corpo Estranho/diagnóstico por imagem , Migração de Corpo Estranho/cirurgia , Traumatismos Cardíacos/diagnóstico por imagem , Traumatismos Cardíacos/cirurgia , Humanos , Masculino , Resultado do TratamentoRESUMO
The frequency and significance of right hepatic artery injury associated with bile duct injury after laparoscopic cholecystectomy is unknown. Many reports suggest that a concomitant arterial injury worsens the outcome and prognosis of the bile duct injury even after an initially successful biliary repair. The optimal management of this complicated injury is controversial. We report a surgical technique to repair the right hepatic artery injury in these cases. We believe this technique is useful for surgeons who opt to repair the arterial injury at the time of biliary reconstruction, especially if it is performed soon after the injury occurred, before permanent damage to the liver and biliary system is established. To the best of our knowledge, this technique was not reported in the literature previously.
Assuntos
Ductos Biliares/lesões , Colecistectomia Laparoscópica/efeitos adversos , Artéria Gastroepiploica/cirurgia , Artéria Hepática/lesões , Veia Safena/transplante , Idoso , Anastomose em-Y de Roux , Colangiopancreatografia Retrógrada Endoscópica , Coledocolitíase/cirurgia , Feminino , HumanosRESUMO
This is a report of a patient with an atrial septal defect with right-to-left shunting, flail tricuspid valve, and complete heart block secondary to blunt chest trauma after a motor vehicle accident. The patient surgically repaired with pericardial recreation of atrial septum, bioprosthetic tricuspid valve replacement, and pacemaker insertion. The patient had minimal problems during the hospital course and subsequently made a full postsurgical recovery.
