Recently, the frequency of maxillofacial injuries has increased and the causes have diversified. Blast injuries due to explosions can be life-threatening. We report a case of blast injury requiring emergency surgery for a mandibular fracture with active bleeding. A 59-year-old woman presented with an injury to the right face with hemorrhage, caused by a gas canister explosion at her home. She was transferred to the Emergency and Critical Care Center of our hospital. Her vital signs were normal and she was alert with a Glasgow Coma Scale score of 15; however, a penetrating wound of the right buccal region and active bleeding in the oral cavity were found. Contrast computed tomography revealed a right mandibular fracture and extravasation around the fracture region. There was a risk of airway obstruction from active oral cavity bleeding; therefore, we performed urgent open reduction and internal fixation for hemostasis. She received an intraoperative blood transfusion and hemostasis was achieved with good reduction and fixation. Fortunately, she had no other injuries and her clinical course was good. It is crucial to understand the unique mechanisms underlying a blast injury, and to perform appropriate clinical evaluation and treatment because of the possibility of head and neck injury, damaged neck vessels, and airway obstruction.
