안와하벽재건술 후 발생한 지연성 눈뒤출혈: 증례보고

Delayed Retrobulbar Hemorrhage after Orbital Floor Reconstruction

  • 이승우 (인제대학교 의과대학 상계백병원 성형외과학교실) ;
  • 최영웅 (인제대학교 의과대학 상계백병원 성형외과학교실) ;
  • 남상현 (인제대학교 의과대학 상계백병원 성형외과학교실) ;
  • 김훈 (인제대학교 의과대학 상계백병원 성형외과학교실)
  • Lee, Seung-Woo (Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Choi, Young-Woong (Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Nam, Sang-Hyun (Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Kim, Hoon (Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine)
  • 투고 : 2010.04.09
  • 심사 : 2010.06.11
  • 발행 : 2010.07.10

초록

Purpose: Retrobulbar hemorrhage is a rare complication followed by blepharoplasty, trauma, orbital reconstruction, and so on. Most of the cases occur within 24 hours, half of them in the first 6 hours. Some authors have reported delayed retrobulbar hemorrhage after blepharoplasty and trauma within 1 day to 9 days. However, there have been few reports of delayed retrobulbar hemorrhage resulting from the complication of orbital reconstruction. Methods: A 22-year-old male underwent orbital floor reconstruction due to the orbital floor fracture. In 84 hours after the surgery, he complained sudden onset orbital pain and decreased visual acuity immediately after defecation. Intraocular pressure was unmeasurable due to the swelling at that time. Emergency computed tomography was performed. Results: Computed tomography revealed subperiosteal hematoma on inferior orbital wall extended to the apex. Emergency decompressive surgery was performed within 1 hour. After evacuation of hematoma, orbital symptom was improved and visual acuity was restored. Conclusion: Delayed retrobulbar hemorrhage is rare but vision-threatening. Therefore early diagnosis and treatment of delayed retrobulbar hemorrhage is thought to be crucial. The cause of delayed hemorrhage was not clear, however, valsalva maneuver might be the cause of hemorrhage.

키워드

참고문헌

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