압축공기에 수상 후 안와골절 없이 안구운동제한 소견을 보인 안와기종 1예
Orbital Emphysema Causing Eye Movement Restriction Without Orbital Fractures Due to Compressed Air Injury
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서론: 압축공기에 수상 후 안와골절 없이 결막열상에 의한 안와기종으로 안구운동장애가 발생한 환자 1예를 보고하고자 한다. 증례요약: 28세 남자가 에어건으로 작업 중 압축공기에 좌안을 수상하여 내원하였다. 좌측 상하안검 부종 및 피하기종, 촉진 시 염발음이 있었다. 제1안위에서 경도의 외사시 및 하사시, 안구운동에서 상전장애가 있었고 오심, 구토 증상은 없었다. 세극등현미경 검사시 결막열상과 함께 결막하 공기방울들이 관찰되었다. 안와 전산화단층촬영에서 상하안검에 피하기종 및 안와내 상직근 위쪽과 원추내 시신경을 둘러싼 안와기종이 관찰되었고 안와벽의 골절은 없었다. 결막열상 일차봉합술 시행 후 경과관찰을 하였으며 외상 4일후 안검부종은 감소하였고 사시, 상전장애, 촉진 시 염발음 및 복시는 모두 소실되었다. 결론: 압축공기로 인하여 안와골절의 동반 없이 결막열상을 통하여 발생하는 안와기종은 안구운동장애를 유발할 수 있다.
Abstract
Purpose: The authors experienced a case of orbital emphysema causing eye movement disorder following conjunctival tear without any orbital wall fractures after exposure to compressed air. Case summary: A 28-year-old man’s left periorbital area was injured while working with compressed air. There was marked lid swelling on the left side with palpable crepitus. The patient had an exotropia and hypertropia of the left eye. In addition, the extraocular movement of the left eye was restricted on upgaze without nausea and vomiting. On slit-lamp examination,conjunctival partial laceration and subconjunctival air bubbles adjacent to the conjunctival laceration could be seen. Orbital computed tomography showed air in the periorbital and retrobulbar region of the left eye and no evidence of orbital fracture. On examination 4 days after the primary repair of the conjunctival laceration, the patient completely recovered without any complication. Conclusions: Orbital emphysema following a conjunctival laceration caused by compressed air without any orbital wall fractures can cause restriction of eye movement.
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