Abstract
Facial trauma, which is occasionally encountered in emergency medicine, may lead to hemorrhagic shock, particularly when accompanied by fractures of the facial bones. We herein report a case of hemorrhagic shock due to minor facial trauma that did not involve facial fractures. An 88-year-old Japanese man was admitted to the emergency room with epistaxis and a flap-like laceration from the right side of the nose to the upper lip. The patient was hypotensive and in shock, with continuous bleeding from the wound. The volume of blood loss was estimated to be 800 mL based on information provided by ambulance attendants. The patient recovered from shock after adequate fluid resuscitation, blood transfusion, and hemostatic treatment. The flap-like wound was repaired via primary intention and healed without necrosis of the skin flap. Hemorrhagic shock may occur with seemingly minor facial trauma. Therefore, it is important to thoroughly examine the lesions and attempt to close them as completely as possible. This case is novel in that the patient had hemorrhagic shock resulting from facial trauma that did not involve facial fractures.
Patient’s wound after electrocautery treatment to stop bleeding.
Fullsize Image
(a) Right anterior oblique aspect. (b) Axial slices from computed tomography (CT) during emergency treatment. Some fluid accumulation was noted; however, there were no signs of zygomatic fracture. (c) Coronal CT slices of computed tomography during emergency treatment. Each nasal concha was intact, and no fluid accumulation was observed. A flap-like wound was observed extending from the right side of the nose, including the tip, to the upper lip.
