第全国消化道恶性病变介入诊疗研.pptxVIP

会计学1第全国消化道恶性病变介入诊疗研 Diagnosis? This child presented with diplopia following blunt trauma to the right eye. On exam, he was unable to move his right eyeball up on upward gaze.第1页/共22页 Blowout Fracture of the OrbitFractures of the orbital floor may occur with orbital wall fractures or as an isolated injury. The isolated injury is usually caused by application of pressure to the globe of the eye by objects with a radius of curvature of 5 cm or less. When the orbital floor, being the weakest area, gives way, herniation of orbital contents down into the maxillary sinus may occur (hanging drop sign).Patients may present with enophthalmos, impaired ocular motility, diplopia due to entrapment of the inferior rectus muscle within the fracture fragments, and infraorbital hypoesthesia. 第2页/共22页 CT: Blowout Fracture of OrbitA: Orbital blowout fracture with displacement of the floor (arrow), distortion of the inferior rectus, and herniation of orbital fat through defect. Arrowhead indicates medial fracture.B: Note opacified left anterior ethmoid air cells and displaced medial orbital fracture (arrowheads).第3页/共22页 Approach to the Patient with Traumatic Injury of the FaceFacial trauma is defined as injury to the soft tissues of the face (including the ears) and to the facial bony structures.May result in hemorrhage and airway obstruction accompanied by multisystem involvement (as many as 60% of patients have associated injuries)Evaluation includes history, physical exam, and diagnostic imaging 第4页/共22页 History of Traumatic EventWhat was the mechanism of injury?Was the patient mobile, restrained, or stationary?Is the injury the result of blunt or penetrating trauma?Was the object that caused the injury mobile or stationary?Can the degree of energy transfer be estimated?Are there any associated thermal or chemical injuries present?第5页/共22页 Additional HistoryWhere is the location of any facial pain or numbness?Are there vision problems, such as diplopia, present?Does movement of th