Neck hematoma caused by spontaneous common carotid artery rupture

The Laryngoscope
Dimitar Dimitrov PazardzhiklievDrago Dragov Zhelev

Abstract

We present a case of an 83-year-old male without previous history who presented with a cervical hematoma, initially misdiagnosed as a neck phlegmona. In the course of the diagnostic workup, the hematoma enlarged, thereby causing respiratory distress because of upper airway compromise. The endotracheal intubation was lifesaving. Later, contrast enhanced computed tomography revealed hematoma in the region of the left common carotid artery. Emergency surgery evacuated the hematoma and repaired a slit-like defect of the left common carotid 2 cm before bifurcation. The patient was discharged on the seventh postoperative day in good condition. We discuss four aspects of the case, namely, the rarity of the condition and the variety of causes, the diagnostic and treatment strategy, the uncertain reasons for spontaneous ruptures of the carotid, and the operative techniques for hematoma evacuation and definitive hemostasis. The optimal strategy for cases of cervical hematoma is the following: intubation, diagnosis, and surgery.

References

Jul 6, 2012·HNO·V M HofmannA Pudszuhn
Jul 16, 2011·The Kaohsiung Journal of Medical Sciences·Chang-Peng Chen, Miao-Chun Yang
Feb 15, 2015·Annals of Vascular Surgery·Felice PecoraroGuido Bajardi
Jun 19, 2018·Annals of the Royal College of Surgeons of England·R SaghirT Rix

Citations

Oct 1, 1991·European Journal of Vascular Surgery·M Miyauchi, S Shionoya
Jul 1, 1986·Japanese Heart Journal·Y SekoH Kurihara
Aug 1, 1982·Archives of Otolaryngology·G Mogi, K Kado
Dec 28, 1999·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·S H RahmanJ A Thorpe

Related Concepts

Common Carotid Artery
Myopathy
Anatomic Bifurcation
X-Ray Computed Tomography
Thyroid Hormone Plasma Membrane Transport Defect
Etiology
Differential Diagnosis
Entire Common Carotid Artery
Neck
Internal Carotid Artery Diseases

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