This clinical report details the development and successful management of a unilateral retrobulbar hemorrhage following maxillary nerve block. Management of this condition requires prompt recognition and treatment to prevent permanent damage to the eye. The cornerstone of treatment is drainage, which rapidly decreases the increased intraorbital and intraocular pressure. To our knowledge, this is the first documentation of this complication in the English language literature.
This case report describes the occurrence of a rapidly-developing pneumoretroperitoneum during coeliotomy in an anaesthetised cat. This was the first indication of a problem, however inadvertent endobronchial intubation initially, and accidental extubation, had occurred in the period immediately prior to surgery. The presence of the pneumoretroperitoneum alerted the clinicians to the likelihood of airway trauma, and mechanical ventilation was discontinued immediately. After completion of the coeliotomy, surgical exploration of the cervical trachea failed to detect an obvious tracheal tear. Subsequent chest radiographs confirmed the presence of pneumoretroperitoneum, pneumomediastinum, mild pneumothorax and subcutaneous emphysema in the cervical region. No further diagnostics were performed, thus the site of the tear could not be definitively diagnosed but was suspected to be distal to the thoracic inlet. The cat recovered uneventfully and was discharged three days later after conservative management. This report highlights the ability to rapidly recognise acute airway trauma by the presence of pneumoretroperitoneum, prompting immediate cessation of positive-pressure ventilation which, if continued, could have exacerbated the pneumothorax in this case.
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