ABSTRACT
We present a case in which a patient with intraorbital Langerhans' cell granuloma, with anatomical and functional skills compromised by intraorbital hypertension, which was treated with urgency orbitotomy by cranial approach. Male, two years-old, presented conjuntival proptosis, red eye, complete ophthalmoplegy, exophthalmos, with non-fotoreactive mydriasis and blepharoptosis of the right eye. Fundoscopy presented venous enlargement with optic disc edema. A cranial approach with orbitotomy was carried out, removed the lesion with total remission of clinical presentation and anatomic appearance as well. The handling of Langerhans' cell granuloma can vary from primary surgical approach as corticotherapy to chemotherapy and radiotherapy. In this case, the surgery was the first option due to the imminent risk of loss of visual function.
Subject(s)
Eosinophilic Granuloma/surgery , Orbital Diseases/surgery , Child, Preschool , Eosinophilic Granuloma/pathology , Histiocytosis, Langerhans-Cell/pathology , Histiocytosis, Langerhans-Cell/surgery , Humans , Male , Ophthalmologic Surgical Procedures/methods , Orbital Diseases/pathology , Visual Acuity/physiologyABSTRACT
Apresentamos um caso no qual foi realizada orbitotomia de urgência em paciente com granuloma de células de Langerhans intraorbitário o qual apresentava comprometimento anatômico e funcional da função visual devido à hipertensão intraorbitária. Paciente masculino, 2 anos, apresentou exoftalmia, proptose conjuntival, olho vermelho, oftalmoplegia completa com midríase não fotorreativa e ptose palpebral direita. À fundoscopia apresentava engurgitamento venoso com edema de papila à direita. Foi realizada abordagem cirúrgica com orbitotomia via intracraniana sendo removida a lesão com remissão total da clínica tanto anatômica quanto funcionalmente. O manejo do granuloma de células de Langerhans pode variar desde a abordagem cirúrgica primária, passando pela terapia com esteróides até quimioterapia e radioterapia. No caso, a cirurgia foi a primeira opção devido ao e iminente risco de perda da função visual.
We present a case in which a patient with intraorbital Langerhans' cell granuloma, with anatomical and functional skills compromised by intraorbital hypertension, which was treated with urgency orbitotomy by cranial approach. Male, two years-old, presented conjuntival proptosis, red eye, complete ophthalmoplegy, exophthalmos, with non-fotoreactive mydriasis and blepharoptosis of the right eye. Fundoscopy presented venous enlargement with optic disc edema. A cranial approach with orbitotomy was carried out, removed the lesion with total remission of clinical presentation and anatomic appearance as well. The handling of Langerhans' cell granuloma can vary from primary surgical approach as corticotherapy to chemotherapy and radiotherapy. In this case, the surgery was the first option due to the imminent risk of loss of visual function.
Subject(s)
Child, Preschool , Humans , Male , Eosinophilic Granuloma/surgery , Orbital Diseases/surgery , Eosinophilic Granuloma/pathology , Histiocytosis, Langerhans-Cell/pathology , Histiocytosis, Langerhans-Cell/surgery , Ophthalmologic Surgical Procedures/methods , Orbital Diseases/pathology , Visual Acuity/physiologyABSTRACT
Este trabalho tem como objetivo revisar os protocolos e definir condutas sobre o atendimento tanto pré-hospitalar quanto o manejo clínico inicial na sala de emergência do paciente com trauma raquimedualr agudo (TRM).