And she cried stones

Introduction In case of acquired lacrimal duct stenosis, various causes come into consideration and especially tumor diseases must be excluded. Since phlegmonous inflammation is associated with a possible cavernous sinus thrombosis and sepsis, the greatest care must be taken.

Case-Report A 62-year-old female patient with chronic dacryocystitis presented with progressive epiphora and painful, phlegmonous swelling of the right half of the face. About 6 months earlier, tear duct irrigation had been performed without complications. After an initially symptom-free interval, the above-mentioned symptoms occurred. An intravenous antibiotic as well as a local antiseptic therapy did not show significant improvement. The ultrasound scan revealed an echogenic mass with posterior acoustic shadow in the area of the right lacrimal sac. Based on these results we performed a surgical exploration of the lacrimal sac. Several (5) dacryoliths within the right lacrimal sac were revealed and successfully removed. After four weeks, a dacryocystorhinostomy could be performed to achieve a definitive solution and provide adequate endonasal drainage.

Conclusion In the case of phlegmonous inflammation of the medial corner of the eye, dacryoliths should be considered as well as in the differential diagnosis, surgical repair should be sought. The surgeon has to take account for the fact that also multiple concrements can be present.

Poster-PDF A-1577.pdf

Conflict of interest

Der Erstautor gibt keinen Interessenskonflikt an.

Publication History

Article published online:
13 May 2021