Pressure Cooker Accident

SavageGlow · #1 ● 06-13-2024, 01:21 AM

A 26-years-old lady presented to the emergency ward with history of trauma to her right eye with the pressure regulator of the pressure cooker while working in kitchen two hours back.

She was conscious and her vitals were within normal limits. There was no perception of light in the right eye, it was auto-eviscerated with exposed uveal tissue and oedematous upper lid. The pressure regulator was seen embedded in the right orbit, abutting medial orbital wall. Blood clots were present in nasal and orbital area along with lacerations over right side of forehead. CT-scan was advised but patient could not afford it. X-Ray showed fracture of medial orbital wall with penetration of the foreign body for approximately three centimetres inside the bony orbit.

Removal of the retained foreign body under local infiltrative anaesthesia with evisceration of the uveal tissue without implant along with primary suturing of the skin lacerations was planned. The foreign body was rotated along its own axis and gently pulled as a single piece via its own track of injury, thus avoiding any injury to surrounding structures. No active haemorrhage was noted from bed of the track, probably owing to cauterization of the surrounding tissue by hot metallic foreign body. After removing debris from the bed, packing with antiseptic (povidone-iodine) and xylometazoline soaked gauze was done. Due to loss of significant amount of soft tissue, primary suturing was not done and the wound was left to heal with secondary intention. Evisceration, suturing of sclera, conjunctiva and skin lacerations was also done in the same sitting.

Post-operative treatment included oral antibiotic and anti-inflammatory medicines. Three months later, the patient was referred to ocularist for custom-made ocular prosthesis.