Orbital varix: A rare case of unilateral exophthalmos, case report
| Autor: | Salissou Iro, Moctar Issiaka, Faiçal Slimani, Hamza Jamaleddine, Mohamed El Belhadji |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Exophthalmos Arteriovenous fistula Case Report Encephalocele Imaging 03 medical and health sciences 0302 clinical medicine medicine Canthus Varix business.industry General Medicine medicine.disease Palpebral fissure 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery Radiology medicine.symptom Varices business Venous malformation Orbit |
| Zdroj: | Annals of Medicine and Surgery |
| ISSN: | 2049-0801 |
| Popis: | The etiologies of unilateral exophthalmos are multiple, rarely represented by an intra- or extra-conical vascular mass. Orbito-palpebral varixes are rare (2% of orbital masses) and represent a main cause of unilateral intermittent exophthalmos, often of an inflammatory nature. We report a Case of right orbito-palpebral varix in a 65-year-old adult, with no particular history, evolving for 2 years. The ophthalmological examination showed a right palpebral mass, extended to the right external canthus, with palpebral collateral circulation, moderate right ptosis with exophthalmos, non-axial, non-pulsatile, without thrill, painless, without complication, without visual deficit. A vascular mass was suspected and MRI revealed a right orbito-palpebral varix with temporal extension, confirmed by ANGIO-MRI. The latter also allowed to search for a cerebral venous malformation, an encephalocele or a bone defect, associated and also to eliminate differential diagnoses (tumor, arteriovenous fistula …). Color Doppler ultrasound in the proclive position confirmed the diagnosis of orbital varices. A preventive low-dose anticoagulant treatment was started to avoid thrombosis, with therapeutic abstention in the absence of complications. A rigorous monthly follow-up in consultation is ensured. Orbito-palpebral varices are characterized by an extensive posterior intra-orbital character, often during their evolution and imposes a strict surveillance. In Case of complication (thrombosis, hemorrhage, pain, compressive signs of the optic nerve), surgical removal or sclerosis of the varix can be envisaged with disappointing results (recurrence, hemorrhage). Highlights • Orbito-palpebral varixes are rare and represent a main cause of unilateral intermittent exophthalmos. • Imaging under appropriate conditions is essential to establish the diagnosis and eliminate differential diagnoses. • Orbito-palpebral varices are characterized by an extensive posterior intra-orbital character, often during their evolution and imposes a strict surveillance. • Surgery is mainly indicated for symptomatic patients with complications or aesthetic damage. |
| Databáze: | OpenAIRE |
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