Bilateral orbital compartment syndrome in a patient with disseminated intravascular coagulation

A 39-year-old male developed bilateral periorbital oedema and tense orbits in keeping with orbital compartment syndrome (OCS) shortly after presenting to the emergency department for uncontrollable epistaxis. Bilateral lateral canthotomy and inferior cantholysis was performed within 30 minutes of on...

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Bibliographic Details
Published in:Orbit (Amsterdam) 2018-09, Vol.37 (5), p.361-363
Main Authors: Huang, Sonia, Sun, Michelle T., Davis, Garry, Fitzgerald, Jude, Selva, Dinesh, Henderson, Tim
Format: Article
Language:English
Subjects:
Adult
Compartment Syndromes - diagnostic imaging
Compartment Syndromes - etiology
Compartment Syndromes - surgery
Decompression, Surgical - methods
disseminated intravascular coagulation
Disseminated Intravascular Coagulation - complications
Disseminated Intravascular Coagulation - diagnostic imaging
Epistaxis - diagnosis
Eyelids - surgery
Humans
Intraocular Pressure - physiology
intraorbital haemorrhage
Male
Ophthalmologic Surgical Procedures
Orbital compartment syndrome
Orbital Diseases - diagnostic imaging
Orbital Diseases - etiology
Orbital Diseases - surgery
Tomography, X-Ray Computed
Visual Acuity - physiology
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Summary:A 39-year-old male developed bilateral periorbital oedema and tense orbits in keeping with orbital compartment syndrome (OCS) shortly after presenting to the emergency department for uncontrollable epistaxis. Bilateral lateral canthotomy and inferior cantholysis was performed within 30 minutes of onset, with the left side further decompressed via superior cantholysis. Computed tomography demonstrated bilateral proptosis and optic nerve stretch, but no intraorbital haemorrhage or haematoma. Laboratory findings were consistent with disseminated intravascular coagulation (DIC) and sepsis of unknown origin. The right visual acuity recovered to 6/6 -2 from counting fingers, but the left eye failed to improve beyond light perception. This unique case of OCS is the first associated with DIC which had no evidence of intraorbital haemorrhage.
ISSN:0167-6830
1744-5108
DOI:10.1080/01676830.2017.1423359