眶内压升高所致眼眶气肿的紧急减压术
Emergency Decompression of Orbital Emphysema with Elevated Intraorbital Pressure.
作者信息
Shameer Abdul, Pushker Neelam, Lokdarshi Gautam, Basheer Shabeer, Bajaj Mandeep S
机构信息
Oculoplastic and Pediatric Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
出版信息
J Emerg Med. 2017 Sep;53(3):405-407. doi: 10.1016/j.jemermed.2016.10.021.
BACKGROUND
A case of orbital emphysema associated with elevated intraorbital pressure, presenting as a complication of a paranasal sinus "blow-out" fracture after trauma to the orbit and globe is presented.
CASE REPORT
A 45-year-old man developed left globe rupture with orbital emphysema after blunt trauma. A large air pocket in the superior orbit with medial wall fracture and globe tenting was identified on noncontrast computed tomography. Direct needle drainage was performed using a 23-gauge needle attached to a saline-filled syringe with the plunger removed. Rapid release of air bubbles with prompt alleviation of pressure symptoms was observed. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Early diagnosis and management of orbital emphysema can salvage useful function of the globe. The knowledge of this clinical entity and its management can prevent delay and unnecessary referral.
背景
本文报告一例眼眶气肿合并眶内压升高的病例，该病例为眼眶和眼球外伤后鼻窦“爆裂性”骨折的并发症。
病例报告
一名45岁男性在钝器伤后发生左眼球破裂并伴有眼眶气肿。非增强计算机断层扫描显示眶上部有一个大气腔，伴有内侧壁骨折和眼球帐篷样改变。使用连接到已移除活塞的盐水注射器的23号针头进行直接穿刺引流。观察到气泡迅速排出，压力症状迅速缓解。急诊医生为何应了解此情况？：眼眶气肿的早期诊断和处理可挽救眼球的有用功能。了解这一临床实体及其处理方法可避免延误和不必要的转诊。
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