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纽扣电池所致严重眼外伤的延迟就诊

Delayed presentation of severe ocular injury from a button battery.

作者信息

Ratnarajan G, Calladine D, Bird K J, Watson S L

机构信息

Department of Ophthalmology, Royal Berkshire NHS Foundation Trust, Reading, Berkshire, UK.

出版信息

BMJ Case Rep. 2013 May 2;2013:bcr2013009094. doi: 10.1136/bcr-2013-009094.

Abstract

A 2-year-old girl presented to the emergency department at 3:00 h with severe pain in her right eye and a rust coloured, blood stained frothy discharge that had woken her. An examination of her eye revealed a shiny metallic looking foreign body, which was immediately removed by the on-call ophthalmologist. That morning the patient underwent ocular examination under anaesthesia and was found to have severe tissue necrosis resulting from an electrochemical burn. She was treated with daily rodding for 3 days and betamethasone ointment four times a day, which was gradually tapered. At 3 months her only eye pathology was a mild symblepharon between the bulbar and tarsal conjunctiva. This is the first case of delayed symptoms after placement of a button battery into the conjunctival fornix. This case highlights the serious nature of button battery injuries to the eye and the potential to miss the diagnosis owing to a delayed onset of symptoms.

摘要

一名2岁女童于凌晨3点因右眼剧痛及铁锈色、带血的泡沫状分泌物被惊醒后前往急诊科。眼部检查发现一个外观闪亮的金属异物,值班眼科医生立即将其取出。当天上午,患者在麻醉下接受了眼部检查,发现因电化学烧伤导致严重的组织坏死。她接受了为期3天的每日泪道探通术治疗,并每天使用4次倍他米松眼膏,用药量逐渐减少。3个月时,她唯一的眼部病变是球结膜与睑结膜之间有轻度睑球粘连。这是首例纽扣电池置入结膜穹窿后出现延迟症状的病例。该病例凸显了纽扣电池眼部损伤的严重性以及因症状延迟出现而可能漏诊的情况。

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本文引用的文献

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J Emerg Med. 2013 Feb;44(2):e187-9. doi: 10.1016/j.jemermed.2012.02.050. Epub 2012 May 18.
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