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Case #22

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Demographics: 11 years old, Male
Indication: Right eye injury

Findings

  • Acute right globe rupture with extensive intra and extraconal retrobulbar orbital hemorrhage, particularly in the superior orbit where there are also multiple locules of intraorbital gas
  • Acute right medial wall, orbital floor, and orbital roof blowout fractures. Fractures involve the nasolacrimal canal and infraorbital foramen. Thin extraaxial hemorrhage overlying the orbital roof fracture with trace pneumocephalus and trace inferior right frontal intraparenchymal hemorrhage. Mild asymmetric rounding of the right inferior rectus muscle. Fractures extend into the anterior and medial walls of the right maxillary sinus with a displaced bony fragment within the sinus
  • Right nasoorbitoethmoid fracture with right nasal arch fractures, the above described right medial orbital wall fracture, and fractures throughout right ethmoid air cells. Right maxillary and ethmoid hemosinus
  • Right facial soft tissue contusion and subcutaneous emphysema

Diagnosis

Globe rupture

Sample Report

Acute right globe rupture with extensive postseptal hemorrhage, particularly in the superior orbit where there are also multiple locules of intraorbital gas. No radiopaque foreign body.

Acute right medial wall, orbital floor,  and orbital roof blowout fractures. Fractures involve the nasolacrimal canal and infraorbital foramen. Thin extraaxial hemorrhage overlying the orbital roof fracture with trace pneumocephalus and trace inferior right frontal intraparenchymal hemorrhage. Recommend dedicated head CT imaging for further evaluation. Mild asymmetric rounding of the right inferior rectus muscle. Recommend correlation with clinical signs of extraocular entrapment. Fractures extend into the anterior and medial walls of the right maxillary sinus with a displaced bony fragment within the sinus.

Right nasoorbitoethmoid fracture with right nasal arch fractures, the above described right medial orbital wall fracture, and fractures throughout right ethmoid air cells. Right maxillary and ethmoid hemosinus.

Right facial soft tissue contusion and subcutaneous emphysema.

Discussion

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