External auditory canal haemorrhage as the first sign of internal carotid artery pseudoaneurysm: a rare case: a case report

Laina Ndapewa Angula,Le Sun,Xin Wang,Ning Fang

doi:10.11604/pamj.2020.37.163.21968

Laina Ndapewa Angula, Le Sun + Show 2 more

Open Access

https://doi.org/10.11604/pamj.2020.37.163.21968

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Journal: The Pan African Medical Journal	Publication Date: Jan 1, 2020
Citations: 1	License type: cc-by

Abstract

Assessing the cause, severity of bleeding and strategies to control bleeding is crucial. We describe a rare case of a patient who was presented with epistaxis and left ear haemorrhage, as a probable complication of a ruptured internal carotid artery pseudoaneurysm. The massive haemorrhage compelled blood transfusion and clinical intervention. The diagnosis of internal carotid artery (ICA) pseudoaneurysm measuring 2.9 cm x 3.7 cm was concluded by computed tomography. Several coils were used to embolize the internal carotid artery pseudoaneurysm and arrest the bleeding with the guidance of an angiography. Coiling the pseudoaneurysm is highly recommended. Yet, the best methods to completely treat aneurysm are still in question. After the clinical intervention, the patient remained symptom-free and no episodes of bleeding were noted.

Highlights

Vascular lesions are severe complications caused by an invasive tumour, blood dyscrasia, penetrating trauma or blunt, or iatrogenic origin [1]
We present a case of epistaxis and massive haemorrhage of the ear due to internal carotid artery pseudoaneurysm, a complication likely stemming from surgical debridement of necrotic fasciitis of the left side of the neck performed previously
The clinical diagnosis of a pseudoaneurysm was confirmed by the carotid angiogram before any kind of treatment is given

Summary

Introduction

Vascular lesions are severe complications caused by an invasive tumour, blood dyscrasia, penetrating trauma or blunt, or iatrogenic origin [1]. Pseudoaneurysm is an unusual vascular complication as a result of a partial injury of an arterial vessel wall, which causes blood flow via the laceration into the neighbouring tissues. This continuous leakage results in a slowly enlarging mass that results in a pseudoaneurysm over time [2]. We present a case of epistaxis and massive haemorrhage of the ear due to internal carotid artery pseudoaneurysm, a complication likely stemming from surgical debridement of necrotic fasciitis of the left side of the neck performed previously. A laryngoscope examination revealed blood stained secretions in the posterior pharyngeal wall.

Discussion

Conclusion