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Delayed rupture of common carotid artery following rugby tackle injury: a case report.

Thakore N, Abbas S, Vanniasingham P - World J Emerg Surg (2008)

Bottom Line: He was promptly intubated and had contrast CT angiography of neck vessels which localized the bleeding spot on posteromedial aspect of his Right CCA.Delayed post traumatic rupture of the CCA is an uncommon yet potentially life threatening condition which can be caused by unusual blunt injury mechanism.A high index of suspicion and low threshold for investigating carotid injuries in the setting of blunt trauma is likely to be beneficial.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Middlemore Hospital, Auckland, New Zealand. nainoor@rediffmail.com.

ABSTRACT

Background: Common Carotid Artery (CCA) is an uncommon site of injury following a blunt trauma, its presentation with spontaneous delayed rupture is even more uncommon and a rugby tackle leading to CCA injury is a rare event. What makes this case unique and very rare is combination of all of the above.

Case presentation: Mr H. presented to the Emergency Department with an expanding neck haematoma and shortness of breath. He was promptly intubated and had contrast CT angiography of neck vessels which localized the bleeding spot on posteromedial aspect of his Right CCA. He underwent emergency surgery with repair of the defect and made an uneventful recovery post operatively.

Conclusion: Delayed post traumatic rupture of the CCA is an uncommon yet potentially life threatening condition which can be caused by unusual blunt injury mechanism. A high index of suspicion and low threshold for investigating carotid injuries in the setting of blunt trauma is likely to be beneficial.

No MeSH data available.


Related in: MedlinePlus

CT angiogram, transverse section showing the haematoma with marked displacement of airway to the left (endotracheal tube in situ).
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Figure 1: CT angiogram, transverse section showing the haematoma with marked displacement of airway to the left (endotracheal tube in situ).

Mentions: He was promptly intubated in resuscitation rooms and taken for CT scanning. CT angiogram of the neck vessels showed active extravasation of contrast from his right CCA (Fig. 1) resulting in the formation of a large haematoma extending superiorly into the parapharyngeal space and inferiorly into the superior mediastinum. It resulted in compression and marked displacement of the airway to the left (Fig. 2). The thyroid gland was also displaced and Internal Jugular Vein was effaced due to compression. Our impression was that he had ruptured pseudo aneurysm of the Right CCA and he was brought forward for emergency surgery.


Delayed rupture of common carotid artery following rugby tackle injury: a case report.

Thakore N, Abbas S, Vanniasingham P - World J Emerg Surg (2008)

CT angiogram, transverse section showing the haematoma with marked displacement of airway to the left (endotracheal tube in situ).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2277436&req=5

Figure 1: CT angiogram, transverse section showing the haematoma with marked displacement of airway to the left (endotracheal tube in situ).
Mentions: He was promptly intubated in resuscitation rooms and taken for CT scanning. CT angiogram of the neck vessels showed active extravasation of contrast from his right CCA (Fig. 1) resulting in the formation of a large haematoma extending superiorly into the parapharyngeal space and inferiorly into the superior mediastinum. It resulted in compression and marked displacement of the airway to the left (Fig. 2). The thyroid gland was also displaced and Internal Jugular Vein was effaced due to compression. Our impression was that he had ruptured pseudo aneurysm of the Right CCA and he was brought forward for emergency surgery.

Bottom Line: He was promptly intubated and had contrast CT angiography of neck vessels which localized the bleeding spot on posteromedial aspect of his Right CCA.Delayed post traumatic rupture of the CCA is an uncommon yet potentially life threatening condition which can be caused by unusual blunt injury mechanism.A high index of suspicion and low threshold for investigating carotid injuries in the setting of blunt trauma is likely to be beneficial.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Middlemore Hospital, Auckland, New Zealand. nainoor@rediffmail.com.

ABSTRACT

Background: Common Carotid Artery (CCA) is an uncommon site of injury following a blunt trauma, its presentation with spontaneous delayed rupture is even more uncommon and a rugby tackle leading to CCA injury is a rare event. What makes this case unique and very rare is combination of all of the above.

Case presentation: Mr H. presented to the Emergency Department with an expanding neck haematoma and shortness of breath. He was promptly intubated and had contrast CT angiography of neck vessels which localized the bleeding spot on posteromedial aspect of his Right CCA. He underwent emergency surgery with repair of the defect and made an uneventful recovery post operatively.

Conclusion: Delayed post traumatic rupture of the CCA is an uncommon yet potentially life threatening condition which can be caused by unusual blunt injury mechanism. A high index of suspicion and low threshold for investigating carotid injuries in the setting of blunt trauma is likely to be beneficial.

No MeSH data available.


Related in: MedlinePlus