Three-Centimeter Bullet in the Orbita of a 2.5-Year-Old Syrian Boy.

Aim of this report is to present a patient who has had a retrobulbar bullet in his left orbit after gunshot injury and had full recovery after surgery. A Syrian boy aged 2.5 years was referred to our emergency after a gunshot injury from left temple. First examination showed stable vital functions; the boy was conscious but had marked proptosis and edema on the left eye. Left intraorbital bullet was observed in X-ray and computed tomography. The exact localization of the bullet and the integrity of the left eye cannot be determined because of shining in computed tomography. Under general anesthesia, lateral and inferior orbitotomy was performed and 3-cm long bullet was excised, which was obliquely localized in the retrobulbar, intraconal area. Ten days later, the patient was sent to his homeland with almost full recovery and minimum sequela.

Usage of lidocaine-prilocaine cream in the treatment of postburn pain in pediatric patients.

BACKGROUND: Facial burns are quite common among children. Many different wound-covers can be used for dressing burn wounds, which is usually painful for the patients. These covers can also be combined with local anesthetic creams. Lidocaine-prilocaine cream 5% (LPC) is commonly used as a topical anesthetic by physicians performing plastic surgery. In the present study, we investigated the effects of topical LPC on pain cessation in pediatric patients with face burn and compared results with a control group in which LPC was not used in the wound dressing. METHODS: Thirty pediatric patients (average age 11.3, range 8-15) among those who admitted to our emergency service and plastic surgery outpatient clinic between 2003 and 2006 were included in this study. The patient's burned areas ranged between 1 and 5% percent of their total body surface. RESULTS: The need for analgesic medicine was recorded in the first, second and third 8-hour periods postburn in both groups, and pain level was evaluated at these time points using a verbal rating scale. There was a significant difference between the two groups with respect to values of the first and second 8-hour periods, while in the third 8-hour period, no significant difference was observed. We conclude that topical local anesthetics administered for 16 hours postburn significantly reduce the duration of pain after injury, which suggests a potential use in clinical practice in the treatment of children with face burn. CONCLUSION: While LPC was found to have an ameliorating effect in the first 16 hours, we recommend oral analgesic co-therapy support since it loses its efficacy in the last 8-hour period.