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巨大眶内木质异物的处理:病例报告

Management of a large intraorbital wooden foreign body: Case report.

作者信息

Jabang John Nute, Dampha Lamin, Sanyang Binta, Roberts Charles Adeyemi, Ceesay Bakary

机构信息

Neurosurgery Unit, Department of Surgery, Edward Francis Small Teaching Hospital.

Department of Surgery, Edward Francis Small Teaching Hospital.

出版信息

Surg Neurol Int. 2020 Jun 20;11:158. doi: 10.25259/SNI_204_2020. eCollection 2020.

Abstract

BACKGROUND

Intraorbital foreign bodies are a global injury and occur with a frequency of one in six orbital injuries; however, intraorbital wooden foreign bodies are uncommon. Intraorbital wooden foreign bodies predominantly affect the male population with a mean age ranging from 21 to 22 years. The diagnosis of intraorbital wooden foreign bodies depending on their size can be challenging on imaging and if not removed early the risk of infection is high.

CASE DESCRIPTION

A 23-year-old motorcyclist presented to the ER following a collision with a donkey cart carrying wood 3 h before presentation. Examination revealed an acutely ill-looking man in painful distress with a right supraorbital laceration associated with ipsilateral ptosis and periorbital edema. There was a retained intraorbital wooden foreign body. Computed tomography scan showed evidence of both an intraorbital bone fragment and a wooden foreign body. Surgery was done 3 day of admission before which vision has declined with only perception to light. Only the wooden foreign body was removed. Evolution was favorable with recovery of vision and improvement of the ptosis.

CONCLUSION

The management of intraorbital wooden foreign bodies demands a multidisciplinary approach after a thorough history, examination, and imaging. Treatment of choice is timely and meticulous removal of the foreign body to avoid infection and other associated complications.

摘要

背景

眶内异物是一种全球性损伤,在眼眶损伤中发生率为六分之一;然而,眶内木质异物并不常见。眶内木质异物主要影响男性人群,平均年龄在21至22岁之间。根据眶内木质异物的大小进行诊断在影像学上可能具有挑战性,如果不及早取出,感染风险很高。

病例描述

一名23岁的摩托车手在就诊前3小时与一辆载有木材的驴车相撞后被送往急诊室。检查发现一名病情危急、面容痛苦的男子,右侧眶上有一处裂伤,伴有同侧上睑下垂和眶周水肿。有一个眶内木质异物残留。计算机断层扫描显示有眶内骨碎片和木质异物。入院第3天进行了手术,术前视力已下降至仅存光感。仅取出了木质异物。病情进展顺利,视力恢复,上睑下垂改善。

结论

眶内木质异物的处理需要在全面了解病史、进行检查和影像学检查后采取多学科方法。首选的治疗方法是及时、细致地取出异物,以避免感染和其他相关并发症。

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