ABSTRACT
Facial and orbital emphysema without any trauma is an uncommon condition that might occur after nose blowing or sneezing efforts. It is usually self-limited and resolves spontaneously within two weeks. Surgical treatment is only reserved in case of complications such as neurological deficiencies or infection of the ocular globe. We report the case of a 42 year-old patient presenting a right spontaneous facial and orbital emphysema following nose blowing, treated by conservative measures, with a systematic review of the literature.
L'emphysème facio-orbitaire atraumatique est un phénomène peu commun pouvant se produire lors du mouchage ou d'éternuements. Il est habituellement contenu et d'évolution spontanément régressive en 2 semaines. Une indication à un traitement chirurgical est réservée en cas de complications telles qu'un déficit neuro-ophtalmique ou une infection du globe oculaire. Nous présentons le cas d'un patient de 42 ans sans antécédent de traumatisme craniofacial, se présentant aux urgences avec un important emphysème facial et intra-orbitaire à droite, spontané survenu lors du mouchage, et traité de manière conservative, ainsi qu'une revue de la littérature.
Subject(s)
Emphysema/etiology , Eye , Face , Orbital Diseases/etiology , Sneezing , Adult , Humans , Paranasal Sinuses , PressureABSTRACT
Hemobilia is an uncommon and potential life-threatening condition mainly due to hepato-biliary tree traumatic or iatrogenic injuries. Spontaneously ruptured aneurysm of the hepatic artery is seldom described. We report the case of an 89-year-old woman presenting with abdominal pain, jaundice and gastrointestinal bleeding, whose ultrasound and computed tomography revealed a non-traumatic, spontaneous aneurysm of the right hepatic artery. The oeso-gastro-duodenoscopy and colonoscopy did not reveal any bleeding at the ampulla of Vater, nor anywhere else. Selective angiography confirmed the diagnosis of hepatic artery aneurysm and revealed a full hepatic artery originating from the superior mesenteric artery. The patient was successfully treated by selective embolization of microcoils. We discuss the etiologies of hemobilia and its treatment with selective embolization, which remains favored over surgical treatment. Although aneurysm of the hepatic artery is rare, especially without trauma, a high index of suspicion is needed in order to ensure appropriate treatment.
