Treatment of an Uncommon High-Pressure Orbital Injection Injury
| Autor: | John P Kelpin, Andrea E Van Pelt, Matthew P Fahrenkopf |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty genetic structures Decompression medicine.medical_treatment Injections Young Adult 03 medical and health sciences Eye Injuries 0302 clinical medicine Pressure medicine Full thickness skin Humans Debridement business.industry 030208 emergency & critical care medicine Surgical wound Skin Transplantation General Medicine Emergency department Decompression Surgical eye diseases Surgery medicine.anatomical_structure Otorhinolaryngology High pressure 030221 ophthalmology & optometry Presentation (obstetrics) Tomography X-Ray Computed business Orbit Orbit (anatomy) |
| Zdroj: | Journal of Craniofacial Surgery. 29:1829-1831 |
| ISSN: | 1536-3732 1049-2275 |
| Popis: | Injection injuries occur most commonly in the hand and digits; however, there are a limited number of reports in the literature describing injection injuries involving the orbit. High-pressure orbital injection injuries pose a number of unique challenges to the treating physician, and the approach to treating these injuries remains controversial. Often times, the extent of tissue damage is not fully appreciated at presentation, which may lead to missed diagnoses or inadequate initial treatment. In this study, the authors describe a rare incidence of high-pressure orbital injection injury. A 19-year-old male presented to the emergency department after injection of his left orbit with oil-based paint. Worsening clinical symptoms and increasing intraocular pressures within the first 24 hours necessitated take back to the operating room for orbital decompression and debridement. After an initial improvement in symptoms, the patient's clinical status deteriorated again, requiring further orbital decompression and additional periorbital debridement. Two weeks after initial presentation, soft tissue reconstruction of the surgical wounds was performed with full thickness skin grafts. The patient's globe and vision were both preserved. Orbital injection injuries, though rare, are potential globe threatening injuries. Physicians should have a low threshold for intervention and patient's must be observed closely over the first 72 hours after injury. Early diagnosis, prompt debridement, and a multidisciplinary approach are keys to improving patient outcomes. |
| Databáze: | OpenAIRE |
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