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一个引人注目的紧握物——眼眶异物

An Eye Capturing Clutch - An Orbital Foreign Body.

作者信息

Das Deepsekhar, Singh Pallavi, Modaboyina Sujeeth, Bajaj Mandeep S, Agrawal Sahil

机构信息

Ophthalmology, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.

Ophthalmology, Civil Hospital, Ahmedabad, Ahmedabad, IND.

出版信息

Cureus. 2021 Jun 23;13(6):e15867. doi: 10.7759/cureus.15867. eCollection 2021 Jun.

DOI:10.7759/cureus.15867
PMID:34327092
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8301275/
Abstract

Foreign bodies inside the orbital cavity are rare. They may lead to serious complications, depending on their nature, size and mechanism of injury. A 29-year-old male presented with a motorcycle handle embedded in his left orbit, with the vision unaffected. Active wound bleeding, increasing hematoma, a low haemoglobin level, signs of hypovolemic shock, ocular acuity and mobility were investigated. A computed tomography scan revealed a long bent metallic object lodged between the globe and floor of the left orbit with fracture of the medial orbital wall and ethmoidal hemosinus with an intact cribriform plate of the ethmoid. An interdepartmental collaborative effort of Oculoplasty, Oro-Maxillofacial and Neurosurgery were utilized in the removal of the foreign body. The patient recovered well after the surgery and a course of antibiotic therapy. A single large round-tipped foreign body in orbit composed of both metal and plastic is an extremely rare incident and fortunately in our case, was relatively harmless despite its large size. The diagnosis and management of intraorbital foreign bodies must be tailored according to their type and a proper localisation by all possible means, blunt dissection, careful haemostasis aided with good lighting, and exposure helps in their atraumatic removal.

摘要

眼眶内的异物很少见。根据其性质、大小和损伤机制,它们可能会导致严重的并发症。一名29岁男性因摩托车把手嵌入左眼眶就诊,视力未受影响。对活动性伤口出血、血肿增大、血红蛋白水平降低、低血容量休克迹象、视力和眼球活动情况进行了检查。计算机断层扫描显示,一个长的弯曲金属物体嵌于左眼眶眼球与眶底之间,眶内侧壁骨折,筛窦积血,筛骨筛板完整。通过眼科整形、口腔颌面外科和神经外科的跨部门协作努力取出了异物。患者术后恢复良好,并接受了一个疗程的抗生素治疗。眼眶内单个由金属和塑料组成的大的圆头异物是极为罕见的情况,幸运的是在我们这个病例中,尽管其体积较大,但相对无害。眶内异物的诊断和处理必须根据其类型进行调整,并通过一切可能的手段进行准确的定位,钝性分离、在良好照明辅助下仔细止血以及充分暴露有助于无创伤地取出异物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1265/8301275/f826d7c70097/cureus-0013-00000015867-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1265/8301275/f826d7c70097/cureus-0013-00000015867-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1265/8301275/f826d7c70097/cureus-0013-00000015867-i01.jpg

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本文引用的文献

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Intraorbital wooden foreign body, legacy of a notorious scrap: a case report.眶内木质异物,一例臭名昭著的碎屑遗留病例报告
BMJ Case Rep. 2021 Apr 15;14(4):e242885. doi: 10.1136/bcr-2021-242885.
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Large organic orbitocranial foreign body.大型有机眶颅异物。
BMJ Case Rep. 2020 Aug 25;13(8):e237186. doi: 10.1136/bcr-2020-237186.
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Fragmented pellet in the orbital apex: a dilemma to remove or not.眶尖部的碎骨片:移除与否的两难困境
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Peri-orbital foreign body: a case report.眶周异物:一例报告
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