Ichiki Akihiro, Takata Keisuke, Hamasaki Ichiro, Moriwake Tadashi
Department of Pediatrics, Iwakuni Clinical Center, Yamaguchi, Japan.
Department of Pediatrics, Iwakuni Clinical Center, Yamaguchi, Japan.
Int J Surg Case Rep. 2025 Jul;132:111441. doi: 10.1016/j.ijscr.2025.111441. Epub 2025 May 14.
Spontaneous pneumomediastinum (SPM) and subcutaneous emphysema (SCE) are well-known complications of asthma. Orbital emphysema (OE) is a rare complication, with little known of its pathogenesis and clinical significance. This report presents a case of OE associated with asthma exacerbation in a pediatric patient.
An 8-year-old girl with a history of asthma treatment developed wheezing and periorbital swelling around her right eye following influenza A infection. She had no history of trauma, nose blowing, or recent surgery. Head and chest computed tomography revealed SPM, massive SCE, and right OE. Intraocular pressure and visual acuity were normal. OE, SCE, and SPM were completely resolved through conservative management, without any sequelae.
OE may be associated with asthma exacerbation in pediatric patients. We hypothesized that the massive SCE and SPM, which developed as a result of asthma exacerbation, spread through the fascial planes, leading to the development of OE.
OE is typically a benign self-limiting condition; however, it may lead to serious complications such as orbital compartment syndrome. Clinicians should consider OE in patients with asthma who present with sudden orbital symptoms, even in the absence of a history of trauma.
自发性纵隔气肿(SPM)和皮下气肿(SCE)是哮喘常见的并发症。眼眶气肿(OE)是一种罕见的并发症,其发病机制和临床意义鲜为人知。本报告介绍了一例小儿患者因哮喘发作并发眼眶气肿的病例。
一名有哮喘治疗史的8岁女孩在感染甲型流感后出现喘息和右眼周围眶周肿胀。她没有外伤、擤鼻或近期手术史。头部和胸部计算机断层扫描显示有SPM、大量SCE和右侧OE。眼压和视力正常。通过保守治疗,OE、SCE和SPM完全消退,无任何后遗症。
小儿患者的OE可能与哮喘发作有关。我们推测,哮喘发作导致大量SCE和SPM,通过筋膜平面扩散,进而导致OE的发生。
OE通常是一种良性自限性疾病;然而,它可能导致严重并发症,如眼眶间隔综合征。即使没有外伤史,临床医生对于出现突发眼眶症状的哮喘患者也应考虑到OE。