Gunshot-Related Periorbital Metallic Foreign Bodies-Case Reports

槍傷引起之眼窩周邊金屬異物－病例報告

林千惠(Chien-Hui Lin) ； 周介仁(Jieh-Ren Jou)

《中華民國眼科醫學會雜誌》 48卷1期 (2009/03) Pp. 41-47

https://doi.org/10.30048/ACTASOS.200903.0006

摘要

目的：報告兩例槍傷造成之眼窩及週邊之金屬異物。
方法：病例報告。
結果：一名13歲無眼科特殊病史的女性，經歷一次兒童玩耍意外不慎導致鋁製BB彈射入患者左眼眼窩內，造成眼球挫傷並合併有玻璃體出血。經我們以手術取出眼窩內異物後2周，病人的視力恢復到20/25且複視症狀消失。一名19歲男性，經歷一次空氣槍射擊意外，導致子彈自左眼下眼窩處射入，經過左篩竇穿過鼻中隔，再穿出右篩竇後，子彈向後射入右蝶竇並停留在右蝶竇內。經照會過耳鼻喉科醫師，其建議此金屬異物不須取出。
結論：若以正確的影像診斷及和適當的處置，眼窩內或鼻竇內金屬異物均可得到良好的預後。

並列摘要

Purpose: To report two types of gunshot orbit injuries, intraorbital and intrasinus, involving metallic foreign bodies.
Methods: We present two case reports.
Results: A 13-year-old girl presented with left orbital pain after being shot with a BB gun. Computed tomographic (CT) scans showed an intraorbital, radio-opaque foreign body in the upper nasal region, near the insertion of the superior rectus muscle. An intraorbital metallic BB bullet was removed by anterior orbitotomy. In the other case, a 19-year-old male was injured by a gunshot to the left cheek region. Both skull X-ray and CT scans showed a radio-opaque foreign body inside the right sphenoid sinus. We did not remove the object because an otolaryngologist suggested that the procedure was unnecessary. The patient was then lost to follow-up.
Conclusions: Retainment of metallic foreign bodies following projectile-induced injuries should be highly suspected. The results of imaging analysis, such as CT scans, should be carefully studied. Treatment includes administration of pain relievers and prophylactic antibiotics and surgical extraction. Accurate diagnosis and appropriate management greatly improves clinical outcome.

並列關鍵字

Metallic foreign body ； Gunshot injury ； CT scans ； Orbit