Shefer Osher, Le Jacqueline, Daas Eshaan, Hu Eugene
Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California.
Clin Pract Cases Emerg Med. 2024 Aug;8(3):311-313. doi: 10.5811/cpcem.19476.
We present a case of a 10-year-old male who developed an atraumatic, nasal septal hematoma with abscess following several days of rhinorrhea and cough. His chief complaint to the emergency department was a two-day history of nasal swelling and discomfort, associated with difficulty breathing through his nose. The patient was well-appearing with swelling and tenderness along the external nasal ridge and nasal septal swelling that occluded both nares. Contrast-enhanced maxillofacial computed tomography revealed a rim-enhancing, fluid-filled collection to the anterior nasal septum. The patient underwent successful incision and drainage by otolaryngology.
Infected septal hematomas are rare but important to recognize as they can result in septal deformity and potentially life-threatening sequelae, such as intracranial infections. Most are secondary to nasal trauma in adult patients. This case highlights a unique presentation of atraumatic septal hematoma with abscess formation in an immunocompetent pediatric patient.
我们报告一例10岁男性患者，在出现数天的流涕和咳嗽后，发生了无创伤性鼻中隔血肿并伴有脓肿。他到急诊科就诊的主要诉求是有两天的鼻肿胀和不适病史，伴有经鼻呼吸困难。患者外观良好，但鼻外嵴有肿胀和压痛，鼻中隔肿胀阻塞了双侧鼻孔。增强型颌面计算机断层扫描显示鼻中隔前部有边缘强化的液性聚集区。患者接受了耳鼻喉科成功的切开引流术。
感染性鼻中隔血肿很少见，但因其可导致鼻中隔畸形以及潜在的危及生命的后遗症，如颅内感染，所以识别出来很重要。在成年患者中，大多数是继发于鼻部创伤。本病例突出了一名免疫功能正常的儿科患者出现无创伤性鼻中隔血肿并形成脓肿的独特表现。
