Pharyngeal Abscess with External Carotid Artery Erosion and Pseudoaneurysm

An 81-year-old male patient presented with complaint of a pulsating neck mass. The patient had a previous history of cervical lymphadenopathy by non-tuberculous mycobacterium infection. Rapid growth of the mass on admission and contrast enhanced computed tomography of the neck resulted in a diagnosis of non-tuberculous mycobacterium induced pseudoaneurysm. The patient underwent emergency open repair of the pseudoaneurysm. Pseudoaneurysm of the common carotid artery is regularly reported, but here we report a rare case of non-tuberculous mycobacterium induced pseudoaneurysm of the common carotid artery.

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“…Successive antibiotic therapy is recommended for 4 to 6 weeks for treatment of remnant infection sources of the lesion [7]. …”

Section: Discussionmentioning

confidence: 99%

Non-Tuberculous Mycobacterium Induced Pseudoaneurysm of the Common Carotid Artery

Lee

Cho

Kim

et al. 2016

Korean J Thorac Cardiovasc Surg

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“…The wound infection rate was only 0.3% [5]. Most ruptures arise from a preexistent inflammation of the carotid artery [6]. Because of their anatomic location, pharyngeal abscesses most frequently involve the internal and less often external carotid artery and favour the carotid bifurcation [6, 7].…”

Section: Discussionmentioning

confidence: 99%

Septic Bleeding of the Common Carotid Artery Following Total Thyroidectomy: An Atypical Complication

Jamaan

Raedecke

Kayser

et al. 2010

Case Reports in Medicine

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Septic rupture of the common carotid artery following total thyroidectomy may rapidly lead to exsanguination. We present a case report of a 16-year-old girl, diagnosed with a questionable thyroglossal duct cyst. Following the initial operative intervention with local excision of the cyst including resection of the medial part of the hyoid bone, pathology revealed papillary carcinoma. Thus secondary total thyroidectomy with locoregional lymphadenectomy was performed. One week later, a wound infection developed, necessitating lavage and drainage. On the 8th postoperative day, a dramatic bleeding of the right common carotid artery occurred. To our knowledge, this is the first reported case in the literature with a septic bleeding of the common carotid artery following total thyroidectomy after one week.

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“…Most ruptures arise from a preexistent mycotic aneurysm of the carotid artery. Wound infections after carotid endarterectomy have joined endocarditis and pharyngeal abscess as the leading causes of carotid mycotic aneurysm [1][2][3][4].…”

mentioning

confidence: 99%

“…Because of their anatomic location, peritonsillar and parapharyngeal abscesses most frequently involve the internal and less often the external carotid artery [2]. Infections after vascular surgery have favored the carotid bifurcation [4].…”

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confidence: 99%

Mycotic aneurysm of common carotid artery induced byStaphylococcus bureus infection after cervical reoperation

Machens

Dralle

2001

World j. surg.

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The objective of this study was to define a novel type of mycotic aneurysm of the carotid artery arising after cervical reoperation. We retrospectively analyzed all staphylococcal mycotic aneurysms of the common carotid artery. These aneurysms had developed after reoperative thyroid or parathyroid surgery, including resection of the central lymph node compartment and cervical reexploration. Mycotic aneurysms were found in three patients, with an incidence of 0.77% (2/261) and 0.62% (1/161) for thyroid and parathyroid reoperations, respectively. Postoperatively, a lymphatic fistula and cervical hematoma emerged in all patients, as did cervical wound infections on days 3, 4, and 6. Deep wound infections were noted on surgical revision. Cultures grew exclusively Staphylococcus aureus, which was resistant to methicillin (MRSA) in one patient. Mycotic aneurysms were identified 1 week after cervical reoperation. One aneurysm was discovered incidentally on planned lavage. The other two aneurysms presented as severe arterial hemorrhages, resulting in exsanguination in one patient. The other two patients had their aneurysms replaced by saphenous venous autografts. There seems to be accelerated arterial media destruction with formation of mycotic aneurysms in staphylococcal wound infections after cervical reoperation. It is important to recognize this novel type of mycotic aneurysm, as it must be repaired immediately to anticipate imminent rupture.

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Pharyngeal Abscess with External Carotid Artery Erosion and Pseudoaneurysm

Abstract: We report the case of a ruptured external carotid artery pseudoaneurysm successfully controlled by angiographic catheter occlusion which allowed subsequent surgical repair.

Cited by 21 publications

References 10 publications

Non-Tuberculous Mycobacterium Induced Pseudoaneurysm of the Common Carotid Artery

Non-Tuberculous Mycobacterium Induced Pseudoaneurysm of the Common Carotid Artery

Septic Bleeding of the Common Carotid Artery Following Total Thyroidectomy: An Atypical Complication

Mycotic aneurysm of common carotid artery induced byStaphylococcus bureus infection after cervical reoperation

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