頭頸部散弾銃創の1例

Shotgun Injury of Head and Neck:Case Report

Ⅰ．はじめに

　わが国では銃による外傷は稀であり，銃弾残存後の自然経過についての報告は見当たらない．

　今回われわれは，散弾銃の暴発により頭頸部に多数の鉛の銃弾が撃ち込まれた患者に対し，可及的に銃弾を摘出し，受傷当日よりキレート剤を用いて鉛中毒の防止に努めた1例を経験したので，文献的考察を加えて報告する．

A 48-year-old male was hit by a shotgun blast from behind while he was hunting. He was only 7 meters away when one of his collegues pulled the trigger accidentally. About 180 lead pellets penetrated his head and neck. When he was brought to our hospital, he was alert and complained of occipital and nape pain, but had no apparent neurologi-cal deficits. We administered 200 mg of dimercaprol immediately and removed 77 pellets by midline suboccipital incision on the next day. Afterwords, we performed four minor operations using a fluoroscope, and removed another 70 pellets by day 29.