Late periorbital haemorrhage following functional endoscopic sinus surgery: a caution for potential day case surgery

Arvind Kumar Arya,David Machin,Hadi Al-Jassim

doi:10.1186/1472-6815-6-11

Abstract

BackgroundOrbital complications following functional endoscopic sinus surgery (FESS) are fortunately rare. They are usually easily and rapidly recognizable.Case presentationWe present an unusual case of a forty-five year old woman who underwent routine FESS and was not packed nasally after the procedure. Six hours later she started bleeding and nasal packs were inserted. She soon developed unilateral periorbital bruising and within hours her condition had worsened so much that the viability of the eye was thrown into question. She underwent medial and lateral canthotomies and made an uneventful post-operative recovery.ConclusionThis rare case demonstrates that late, brisk post-operative bleeding can occur after FESS with potentially catastrophic consequences. Clinicians should be aware that discharging patients after FESS too early may lead to medico-legal problems.

Highlights

Orbital complications following functional endoscopic sinus surgery (FESS) are rare
This rare case demonstrates that late, brisk post-operative bleeding can occur after FESS with potentially catastrophic consequences
Clinicians should be aware that discharging patients after FESS too early may lead to medico-legal problems

Summary

Introduction

Orbital complications following functional endoscopic sinus surgery (FESS) are rare. Conclusion: This rare case demonstrates that late, brisk post-operative bleeding can occur after FESS with potentially catastrophic consequences. Complications reported include orbital plate breach and periorbital haemorrhage, medial rectus muscle damage and optic nerve damage [3]. Late bleeding causing orbital complications following FESS has been reported before [7].

Results

Conclusion