Hosting 723 files, 2930 images, and 4 contributors.

 
Random Case

Necrotizing enterocolitis
Joseph Junewick, MD FACR
over 9 years ago
Enter A Workflow
Standard2   Academic2

Please choose a workflow. A standard workflow allows you to browse the repository with full case detail; the academic workflow allows you to browse the repository with limited case detail revealed. Double click on the images to launch image viewer.

ARSt Case Repository

Congenital Dacrocystocele

Case Detail

Anatomy: Neck-Face
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: 7 months ago
Updated: 2 months ago
Tags: PEDS
Modality/Study Types: CT MR
Activities:
Adobe32 PDF Imagej32 ImageJA

History

Newborn with respiratory distress and inability to pass nasogastric tube.


Case Images


Diagnosis

Congenital Dacrocystocele

Findings

CT – Axial and coronal images (bone and soft tissue algorithm) show medial canthus mass, expanded nasolacrimal canal and cystic mass below the middle meatus, bilaterally, with resultant obstruction of the nasal cavity.

Discussion

Dacryocystoceles are caused by the obstruction of the proximal and distal ends of the nasolacrimal duct. Dacryocystoceles are usually noted at or shortly after birth, and manifest as blue-gray swelling of the skin overlying the lacrimal sac and/or superior displacement of the medial canthal tendon. Although dacryocystocele may be obvious clinically, imaging is needed to help differentiate dacryocystocele from other intranasal masses. CT is preferred. Nasolacrimal duct dilation and a homogenous, thin-walled, fluid-filled mass are commonly seen on CT. Dacryocystoceles can lead to nasal obstruction, dacryocystitis or periorbital and thus require prompt treatment. Conservative management includes lacrimal duct massage for a few months, and if unresolved, ductal probing may be performed. Although rare, ductal intubation may be needed in refractory cases.

Contributor

Ellen J. Junewick, PA-S



Corporate Office: 616.363.7272, 3264 North Evergreen Drive, Grand Rapids, MI 49525

Spectrum Health Helen Devos Childrens Hospital GE HealthCare