[Diagnosis and therapeutic management of an intraorbital organic foreign body]

Management of a large intraorbital wooden foreign body: Case report

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^rd 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.

[Conjunctival granuloma following neglected thorn injury: about a case]

Il est parfois difficile de détecter un corps étranger végétal intraoculaire, principalement dans les cas où l'histoire du traumatisme oculaire n'est pas claire, ou chez les patients qui consultent plusieurs mois après le traumatisme. Nous rapportons un cas rare d'un enfant de 7 ans qui s'est auto traumatisé au niveau de l'œil gauche par une épine végétale de cactus, 3 mois avant son admission, ce qui a entraîné un granulome conjonctival temporal supérieur avec réaction inflammatoire du segment antérieur. L'exploration chirurgicale a été réalisée permettant l'extraction de l'épine avec une exérèse totale du granulome. Une légère amélioration clinique et de l'acuité visuelle a été notée puis le globe oculaire a évolué vers la phtyse quelque mois après l'extraction.

Intraorbital wooden foreign body detected by computed tomography and magnetic resonance imaging

To identify and localize an intraorbital wooden foreign body is often a challenging radiological issue; delayed diagnosis can lead to serious adverse complications. Preliminary radiographic interpretations are often integrated with computed tomography and magnetic resonance, which play a crucial role in reaching the correct definitive diagnosis. We report on a 40 years old male complaining of pain in the right orbit referred to our hospital for evaluation of eyeball pain and double vision with an unclear clinical history. Computed tomography and magnetic resonance scans supposed the presence of an abscess caused by a foreign intraorbital body, confirmed by surgical findings.

[Intraorbital foreign body]

INTRODUCTION

Perforative intraorbital injuries can be potentially serious, and management depends on the type of projectile and its intraorbital trajectory. Medical imaging is an imperative part of the initial assessment.

OBSERVATION

We report the case of a wooden intraorbital foreign body (arrow), with no functional or anatomical consequences, with a remarkable intraorbital trajectory analyzed by CT.

DISCUSSION

The two main risks of these injuries are first mechanical, with possible bulb, nerve, muscle or bone complications, and second infectious. The CT scan or better yet MRI imaging provide a detailed analysis of the projectile's intraorbital trajectory in the orbital cavity. Infectious complications are promoted by the fat cells present in the orbit and must be systematically controlled with wide-spectrum antibiotics.

[An unusual foreign body in the orbit]

INTRODUCTION

Foreign bodies in the orbit are rare. They can generate more or less serious complications depending on their nature and size. We report an exceptional case of a bulky foreign body in the orbit (the tip of a pen), which did not lead to any complication.

OBSERVATION

A 13-year-old child presented with a right orbital trauma caused by a pen. He consulted 3 months later when a small palpebral swelling appeared. The CT scan showed the presence of a foreign body on the orbital floor. Wound debridement allowed extracting the tip of a pen measuring 3.5cm without any complication. There were no postoperative complications.

DISCUSSION

The originality of this observation is two-fold; the singularity of the foreign body and its total harmlessness in spite of its large size. However, orbital trauma and a secondary orbital syndrome must lead to emergency imaging.