Congenital dacryocystocele complicated by acute dacryocystitis in a newborn: a case report and imaging review

Abstract Neonatal dacryocystocele is a rare anomaly resulting from dilation of the lacrimal sac and duct due to congenital nasolacrimal duct obstruction, commonly referred to as congenital dacryostenosis. Although it can resolve spontaneously, it may rarely lead to potentially serious complications such as acute dacryocystitis or nasal respiratory distress, necessitating specialist consultation (ophthalmology and/or ENT) and further laboratory and imaging studies. We report a case of acute dacryocystitis in a newborn with a congenital dacryocystocele who presented since birth with a painful swelling at the left medial canthus, associated with epiphora and nasal discharge. Following an initial ultrasound, CT imaging revealed a soft tissue lesion in the medial canthal region and a left dacryocystocele extending into the nasal fossa that had progressed to acute dacryocystitis. The patient was hospitalized for intravenous antibiotic therapy followed by probing of the nasolacrimal drainage system. This case highlights the importance of prompt diagnosis and appropriate management of nasolacrimal duct anomalies such as complicated dacryocystocele.