| A Case of Surgical Management for Orbital Organizing Hematoma from Orbital Varix. |
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Ji Won Kim, Ka Hyun Lee, Cheol Keun Park, Jin Sook Yoon |
1The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. yoonjs@yuhs.ac
2Department of Ophthalmology, Konyang University College of Medicine, Seoul, Korea.
3Department of Pathology, Yonsei University College of Medicine, Seoul, Korea. |
| 정맥류와 동반하여 발생한 기질화 혈종에 대한 수술적 치료 1예 |
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김지원1⋅이가현2⋅박철근3⋅윤진숙1 |
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연세대학교 의과대학 안과학교실 시기능개발 연구소1, 건양대학교 의과대학 안과학교실2, 연세대학교 의과대학 병리학교실2 |
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Received: 24 April 2015 • Revised: 15 June 2015 • Accepted: 14 August 2015 |
| Abstract |
PURPOSE
Orbital varices, which can lead to proptosis or globe displacement, are caused by Valsalva's maneuver or bending forward. Most of the orbital varices are treated conservatively, but surgical treatment is necessary for severe cosmetic or functional problems. We report a case of orbital organizing hematoma accompanied by an orbital varix which was successfully removed surgically without complications such as intraoperative bleeding. CASE SUMMARY: A 78-year-old female presented with the complaint of 4 mm proptosis and hyperglobus of left eye. Orbit magnetic resonance imaging (MRI) showed a well demarcated extraconal mass in the inferior orbit which appeared to be an orbital varix. Initially, we decided to monitor the patient without surgery because proptosis was reduced to 1 mm within a week. However, after 5 months, the symptoms suddenly worsened, specifically, 4 mm of proptosis with severe hyperglobus and pain. MRI showed a 29.7 x 21.2 x 23.7 mm mass compressing the globe upward. Six weeks of conservative care did not improve the symptoms and we eventually performed an anterior orbitotomy through the inferior conjunctiva. There was a minor bleeding during the surgery. Based on the histological test, the mass was determined to be an organizing hematoma covered by a membrane. At 8 months postoperatively, symptoms had not recurred. CONCLUSIONS: Orbital varices are usually treated conservatively since its surgical removal is known to have risks. Nonetheless, if an MRI shows an orbital organizing hematoma, it can be surgically debulked successfully without complications when a chronic hemorrhage from orbital varix causes serious proptosis and globe deviation. |
| Key Words:
Organizing hematoma;Varix |
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