title: Utility of Magnetic Resonance Imaging in the Surgical Management of Drug Extravasation: A Case Report.
abstract: We report a case of phenytoin extravasation complicated by eschar formation. Pre-operative MRI study showed a large non-enhancing area over the dorsum of the imaged right wrist and hand corresponding with the site of phenytoin extravasation and raising the suspicion of subcutaneous tissue necrosis. The MRI findings correlated well with the intra-operative findings. We believe that pre-operative MRI in drug extravasation cases can characterise the type of soft tissue injury and define the extent of injury. This helps the surgeon in the surgical approach and treatment options.
authors.affiliation: 1 Department of Diagnostic Radiology, Changi General Hospital, Singapore.
authors.forename: Yet Yen
authors.initials: YY
authors.lastname: Yan
authors.affiliation: 1 Department of Diagnostic Radiology, Changi General Hospital, Singapore.
authors.forename: Tein Jin
authors.initials: TJ
authors.lastname: Tan
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D003646:Debridement / Q000379:methods*; D004827:Epilepsy / Q000188:drug therapy; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009336:Necrosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D010672:Phenytoin / Q000009:adverse effects / Q000627:therapeutic use; D057234:Preoperative Period; D014953:Wrist
chemical_list: D000927:Anticonvulsants; D010672:Phenytoin
keywords: Drug extravasation; Magnetic resonance imaging; Tissue necrosis