BMJ case reports
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An 80-year-old woman had the anticoagulant effect of dabigatran etexilate reversed using factor eight inhibitor bypassing activity (FEIBA) in order to facilitate emergency surgery for an incarcerated femoral hernia. She had atrial fibrillation was taking the anticoagulant for stroke prevention. That afternoon her international normalised ratio (INR) was 1.3 and activated partial thromboplastin time ratio (APPTr) was 2.17, having taken dabigatran that morning. 3000 units of FEIBA and 10 mg of vitamin K were administered and she was taken to theatre for emergency surgery. ⋯ She made an uneventful postoperative recovery and was discharged home. There is a limited evidence base guiding practice in the clinical scenario described. The only controlled studies available are animal experiments.
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This article advocates the need for early incision and drainage of periorbital abscesses. We report a case of a 1.5-month-old neonate with orbital cellulitis and periorbital abscess, which had rapidly developed over a period of 3 days. ⋯ A small swelling noted on the left temporal region on discharge from the hospital was treated with oral cotrimoxazole. However, it spread rapidly to involve the periorbital tissue and the bones of the orbital walls to form a periorbital abscess and orbital cellulitis.