Mellington Faye E, Bacon Annette S, Abu-Bakra Mohammed A J, Martinez-Devesa Pablo, Norris Jonathan H
Oxford Eye Hospital, Headington, Oxford, United Kingdom.
Royal Berkshire NHS Foundation Trust, Reading, United Kingdom.
J Emerg Med. 2014 Sep;47(3):e69-72. doi: 10.1016/j.jemermed.2014.04.030. Epub 2014 Jun 7.
Orbital injury secondary to petroleum-based products is rare. We report the first case, to our knowledge, of a combined compressed air and chemical orbital injury, which mimicked necrotizing fasciitis.
A 58-year-old man was repairing his motorcycle engine when a piston inadvertently fired, discharging compressed air and petroleum-based carburetor cleaner into his left eye. He developed surgical emphysema, skin necrosis, and a chemical cellulitis, causing an orbital compartment syndrome. He was treated initially with antibiotics and subsequently with intravenous steroid and orbital decompression surgery. There was almost complete recovery by 4 weeks postsurgery. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Petroleum-based products can cause severe skin irritation and necrosis. Compressed air injury can cause surgical emphysema. When these two mechanisms of injury are combined, the resulting orbitopathy and skin necrosis can mimic necrotizing fasciitis and cause diagnostic confusion. A favorable outcome is achievable with aggressive timely management.
石油基产品继发的眼眶损伤较为罕见。据我们所知，我们报告了首例压缩空气和化学物质联合导致的眼眶损伤病例，该病例类似坏死性筋膜炎。
一名58岁男性在修理摩托车发动机时，活塞意外点火，将压缩空气和石油基化油器清洁剂喷入其左眼。他出现了手术性气肿、皮肤坏死和化学性蜂窝织炎，导致眼眶间隔综合征。他最初接受了抗生素治疗，随后接受了静脉注射类固醇和眼眶减压手术。术后4周时几乎完全康复。急诊医生为何应了解此情况？：石油基产品可导致严重的皮肤刺激和坏死。压缩空气损伤可导致手术性气肿。当这两种损伤机制合并时，由此产生的眼眶病变和皮肤坏死可类似坏死性筋膜炎并导致诊断混乱。积极及时的处理可取得良好预后。
