Massive Facial Bleeding with an Implanted Orbital Penetrating Foreign Body in an Elderly Patient on a Novel Oral Anticoagulant

Nisreen Hamza M Maghraby and François de Champlain

Department of Emergency Medicine, McGill University, Canada

^*Correspondance to: Nisreen Hamza M Maghraby 

 PDF  Full Text Case Report | Open Access

Abstract:

Facial trauma from blunt injury is a common presentation that usually does not require specific emergency intervention. On the other hand, penetrating facial injuries can be quite challenging, as they may compromise airway integrity or, in rare cases, lead to life threatening massive bleeding if not controlled.To our knowledge there are no guidelines or recommendations on how to approach such challenging situations.In this case we present a patient with an initially stable deep facial injury that suddenly deteriorated requiring massive transfusion resuscitation and operative intervention. The situation was complicated by the presence of a Foreign Body (FB), which limited the amount of pressure that could be applied.Given the above, we reviewed the available literature on massive traumatic facial bleeding for possible alternative approaches to such a situation. Our findings can be summarized in a stepwise approach as follows: pressure, nasal packing, surgical ligation, and selective embolization of the external carotid artery or its branches.

Keywords:

Penetrating facial trauma; Bleeding facial laceration; Massive bleeding; Novel oral anticoagulant

Cite the Article:

Maghraby NHM, de Champlain F. Massive Facial Bleeding with an Implanted Orbital Penetrating Foreign Body in an Elderly Patient on a Novel Oral Anticoagulant. Ann Clin Case Rep. 2019; 4: 1672.