Dai Dairui, Meyer Silke, Kaltheuner Lars Christian, Plani Frank
Department of Medicine, University College London Medical School, London, UK.
Department of Medicine, Universitatsmedizin Greifswald, Greifswald, Germany.
BMJ Case Rep. 2018 Sep 23;2018:bcr-2018-226054. doi: 10.1136/bcr-2018-226054.
A 25-year-old man presented to the trauma department following a penetrating stab wound to his left infraorbital margin with retained knife blade causing superoposterior displacement of the globe. Plain skull X-ray revealed an extensive retained blade with subsequent CT imaging revealing the tip of the blade had reached the right styloid process with no neurovascular compromise. Initial concern was primarily for the left eye leading to ophthalmology being the first specialty requested to review the patient. However, once the extent of the injury was established, ophthalmology requested further review from maxillofacial, ENT and neurosurgery. This resulted in an 84 hours wait between the initial injury and the removal of the knife blade. Incredibly, the patient had no initial sequelae from such an extensive injury and had an unremarkable recovery with no further complications aside from a laceration to the left inferior rectus muscle that was conservatively managed.
一名25岁男性因左眶下缘被刺伤且刀片残留导致眼球向后上方移位，被送至创伤科。颅骨平片显示刀片广泛残留，随后的CT成像显示刀片尖端已到达右侧茎突，未造成神经血管损伤。最初主要担心的是左眼问题，因此眼科成为首个被要求会诊该患者的专科。然而，一旦确定了损伤范围，眼科便要求颌面外科、耳鼻喉科和神经外科进一步会诊。这导致从最初受伤到取出刀片之间等待了84小时。令人难以置信的是，该患者在遭受如此严重的损伤后最初并无后遗症，恢复过程顺利，除了左下直肌撕裂伤经保守治疗外，没有出现其他并发症。
