Cranial Maxillofac Trauma Reconstruction 2018; 11(03): 219-223
DOI: 10.1055/s-0037-1603454
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Lingual Artery Pseudoaneurysm after Severe Facial Trauma

Leyre Margallo
1  Department of Oral and Maxillofacial Surgery, Hospital Universitario Cruces, BioCruces Health Research Institute, Bizkaia, Spain
,
Estibaliz Ortiz de Zárate
1  Department of Oral and Maxillofacial Surgery, Hospital Universitario Cruces, BioCruces Health Research Institute, Bizkaia, Spain
,
Maria Franco
1  Department of Oral and Maxillofacial Surgery, Hospital Universitario Cruces, BioCruces Health Research Institute, Bizkaia, Spain
,
Maria Garcia-Iruretagoyena
1  Department of Oral and Maxillofacial Surgery, Hospital Universitario Cruces, BioCruces Health Research Institute, Bizkaia, Spain
,
Rosa Cherro
1  Department of Oral and Maxillofacial Surgery, Hospital Universitario Cruces, BioCruces Health Research Institute, Bizkaia, Spain
,
Luis Barbier
1  Department of Oral and Maxillofacial Surgery, Hospital Universitario Cruces, BioCruces Health Research Institute, Bizkaia, Spain
,
Josu Mendiola
2  Department of Radiology, Hospital Universitario Cruces, BioCruces Health Research Institute, Bizkaia, Spain
,
Thomas Constantinescu
3  Division of Plastic Surgery, Humber River Hospital, Toronto, Ontario, Canada
› Author Affiliations
Funding The authors have no financial disclosures or sources of support.
Further Information

Publication History

20 August 2016

05 February 2017

Publication Date:
18 May 2017 (eFirst)

Abstract

The mortality associated with high-energy trauma has several time peaks and variable prognosis. In the particular case of isolated head and neck trauma, management initially includes stabilizing the patient, especially the airway and circulation, and then proceeding to treat injured structures with debridement and often fracture fixation and coverage. We present a case of a male patient who suffered a severe facial trauma at his workplace. He underwent an initial uneventful emergency surgery for control of bleeding and mandibular osteosynthesis. At 2 weeks postoperatively, a second emergency surgery was required to treat a previously undiagnosed lingual pseudoaneurysm that ruptured spontaneously, with massive oral bleeding. The case highlights the clinical significance and timing of pseudoaneurysm formation, and the surveillance and high index of suspicion required for potentially life-threatening bleeding at later time peaks. Diagnostic and therapeutic angiography effectively treated the late complication. Multidisciplinary management options are reviewed, emphasizing the need for rapid decision making and collaboration to improve outcomes in such significant surgical trauma patients.