Document Detail

Profuse epistaxis following sphenoid surgery: a ruptured carotid artery pseudoaneurysm and its management.
MedLine Citation:
PMID:  18501041     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We report a rare case of iatrogenic pseudoaneurysm of the internal carotid artery secondary to endoscopic sphenoid surgery. METHOD: The management of this unusual complication and a review of the literature are presented. RESULTS: A 65-year-old woman presented with intractable epistaxis four days following endoscopic sphenoid sinus surgery. Initial, conservative measures were unsuccessful in controlling bleeding. The clinical picture of delayed, severe epistaxis after a sphenoid sinus exploration raised the possibility of injury to the internal carotid artery and subsequent formation of a false aneurysm. The patient's pseudoaneurysm was managed, without visualising it, by packing the sphenoid sinus (achieved by palpating 1 cm above the shoulder of the posterior choana) in order to gain control of the haemorrhage, followed by endovascular occlusion. CONCLUSION: An awareness of this rare complication is essential in order to manage this life-threatening condition efficiently.
D Biswas; A Daudia; N S Jones; N S McConachie
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-05-23
Journal Detail:
Title:  The Journal of laryngology and otology     Volume:  123     ISSN:  1748-5460     ISO Abbreviation:  J Laryngol Otol     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-28     Completed Date:  2010-01-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706896     Medline TA:  J Laryngol Otol     Country:  England    
Other Details:
Languages:  eng     Pagination:  692-4     Citation Subset:  AIM; IM    
Department of Otolaryngology and Head and Neck Surgery, Queens Medical Centre, University of Nottingham, UK.
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MeSH Terms
Aneurysm, False / etiology,  therapy*
Carotid Artery Injuries / therapy*
Carotid Artery, Internal*
Epistaxis / etiology*
Iatrogenic Disease
Postoperative Hemorrhage / etiology*
Sphenoid Sinus / surgery*

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