Rare accident
According to the family, after school, the baby was taken by his parents to eat grilled skewers. While holding the skewer while running around, the baby unfortunately tripped and fell, causing the sharp skewer to pierce straight into the middle of his face.
The accident happened in just a few seconds but caused the whole family to panic when the head of the bamboo stick was stuck deeply close to the left eye. The baby was in pain, cried continuously and was taken to the local hospital for emergency treatment before being transferred to Viet Duc Friendship Hospital that night.
When admitted to the hospital, the foreign object was still deeply stuck from the base of the nose diagonally up to the left eye socket. What worries doctors the most is that they cannot determine how deep the pointed end of the bamboo stick has gone.
Assoc. Prof. Dr. Nguyen Hong Ha - Head of the Department of Maxillofacial Surgery - Plastic Surgery and Aesthetics - said that this is a particularly difficult emergency situation because the patient is too young, panicked and cannot coordinate examination.
Doctors only know that there is a sharp foreign object piercing from the base of the nose into the eye socket, but it is not possible to determine whether it has punctured the eyeball, penetrated the skull or caused important damage to blood vessels and nerves," Assoc. Prof. Ha said.
According to doctors, if you arbitrarily remove the foreign object, it can cause massive bleeding, nerve damage or severe traumatic brain complications. The biggest difficulty is that the bamboo foreign object is almost non-blocking on conventional X-rays, so it is very difficult to determine the exact path.
Notably, after the accident, the exposed bamboo stick part was cut off for convenient transportation of the patient, but the cut part was later lost, making it almost impossible to estimate the depth of the foreign object.
On the same night, the hospital activated a multi-specialized consultation with the participation of doctors in Maxillofacial Surgery, Neurosurgery, Cardiology - Thoracic Surgery, Anesthesia and Resuscitation and Diagnostic Imaging.
Experts had to directly go to the multi-slice CT room to create 3D images, review each thin slice to track the path of the foreign object.
According to doctors, on the CT scan, the pieces of grilled meat clinging to the bamboo stick are quite clear, but the pointed end of the stick is only blurred. "At one point, we had to indirectly reason: which structure has not been seen damaged, then hopefully the foreign object has not penetrated that position," Assoc. Prof. Ha shared.
The position where the skewer passes is particularly dangerous because the nasal base - eye socket area contains many vital structures such as the eyeball, optic nerve, eye artery, anterior skull base and cave sinus containing large blood vessels of the brain.
If the foreign object pierces the eyeball, the child is at risk of permanent blindness. If it penetrates deep into the skull, the patient may have a brain infection, cerebrospinal fluid leakage, intracranial bleeding or die immediately during surgery.
Emergency surgery, millimeter-to-millimeter damage control
In the context that diagnosis is still difficult, doctors are forced to order emergency surgery to avoid the risk of serious complications.
For nearly an hour of surgery, the team had to follow the direction of the skewer, revealing and controlling every millimeter of damage before removing the foreign object.
Fortunately, after removing all the bamboo sticks, the patient did not have massive bleeding or cerebrospinal fluid leakage. The left eyeball was intact and still maintained its tension.
MSc.BS Nguyen Thi Huong Giang - Department of Maxillofacial Surgery - Plastic Surgery and Aesthetics - said that this is an extremely rare and lucky case.
The meat skewer is sharpened, so it can completely pierce the eyeball very easily. The foreign object has gone from the base of the nose through the muscle and tissue layer above the eyeball and stopped at the top of the eye socket, just before piercing into the skull," the doctor said.
After 5 days of surgery, the patient's condition gradually stabilized. The child is awake, plays well, has no fever. The left eye is still slightly swollen but still maintains vision. However, eyeball movement is still limited and it is necessary to continue monitoring the risk of infection and neurocerebral complications.
Assoc. Prof. Dr. Nguyen Hong Ha warned that accidents caused by meat skewers, chopsticks, bamboo toothpicks, candy sticks, pens... in young children can cause particularly serious consequences.
Parents should not let children eat while running and jumping, and should remove food from the skewers before feeding them. If the child is stabbed by a sharp object, absolutely do not arbitrarily remove the foreign object but need to quickly take them to a specialized medical facility," Assoc. Prof. Ha advised.
