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患者,男,39岁,以右眼红、痛入院。他受到一个老者暗示将自己的右眼用木棒击伤。临床表现为右眼中度突出,完全性眼肌麻痹和严重眶周皮肤肿胀。眼科影像学表现为右眼眼窝蜂窝组织炎及眼下静脉血栓形成,两侧海绵窦综合征和海绵窦血栓。报告中无眼内及眶内异物。积极使用静脉抗生素,患者的病情并没有得到改善。在麻醉下检查发现在穹窿下有一个巨大的木质异物。异物去除及强力抗生素治疗下患者病情明显恢复。诊断中发现受伤原因可能是由这个精神病患者自我伤害引起。详细的病史、检查及合理的调查揭示其潜在的病因。敏锐的察觉及相关的临床发现与影像学研究在眶内异物及眶蜂窝组织炎处理中显得尤为有效的。及时诊断和治疗可能进一步减少患者的发病率或死亡率。
Patient, male, 39 years old, with right eye red and pain into hospital. He was hinted by an old man to wreck his right eye with a stick. Clinical manifestations of moderately prominent right eye, complete ophthalmoplegia and severe periorbital skin swelling. Ophthalmic imaging showed right eye orbital cellulitis and immediate venous thrombosis, both sides of the cavernous sinus syndrome and cavernous sinus thrombosis. No intraocular or intraorbital foreign bodies were reported in the report. Active use of intravenous antibiotics, the patient’s condition has not been improved. Under anesthesia examination revealed a huge wooden foreign body under the fornix. Foreign body removal and strong antibiotic treatment significantly recovered the patient’s condition. The cause of the injury found in the diagnosis may be caused by self-harm by this psychiatric patient. Detailed medical history, examination and reasonable investigation reveal its underlying causes. Sensitive perceptions and associated clinical findings and imaging studies are particularly effective in treating orbital foreign bodies and orbital cellulitis. Timely diagnosis and treatment may further reduce morbidity or mortality in patients.