급성 눈물주머니염에 합병된 안와연조직염 및 안와농양

Orbital Cellulitis and Orbital Abscess Secondary to Acute Dacryocystitis

Purpose: To report a case of orbital cellulitis and orbital abscess secondary to acute dacryocystitis. Case summary: A 56-year-old man with eyelid swelling on the left eye hit by a car door was diagnosed with orbital cellulitis at a local clinic and was treated with oral antibiotics for days. However, the symptoms got worse and the patient was referred for assessment. The patient had severe eyelid and conjunctival swelling on the left eye with decreased visual acuity with proptosis. We obtained a contrast-enhanced computed tomography (CT) scan, which demonstrated dacryocystitis with orbital cellulitis, sinusitis of left maxillary and ethmoid sinus. Endoscopic endonasal dacryocystorhinostomy and functional endoscopic sinus surgery at the ear, nose, and throat department was done to treat the patient. The day after the operation, eyelid swelling and proptosis were better than the previous day. But the next day, symptoms got worse so we obtained a follow-up contrast-enhanced CT scan, which demonstrated increased soft tissue attenuation medially medial rectus muscle. These findings in the CT scan were thought of as orbital abscess, so surgical incision and drainage was done. After the operation, pain, eyelid and conjunctival swelling were decreased and the best-corrected visual acuity of the left eye was recovered to 1.2. Conclusions: In adults, orbital cellulitis is mostly caused by sinusitis, but we should consider that it could be caused by acute dacryocystitis.