The perplexing postsurgical complication of carotid-jugular fistula: A bitter experience

Abstract

Background: Vascular injuries occur in approximately 25% of all penetrating neck traumas, with carotid artery injuries being particularly lethal. Penetrating neck injuries are potentially fatal. Vascular injuries occur in approximately 25% of cases, which can lead to the formation of arteriovenous fistulas. Case Description: The authors present a case of delayed open surgery to repair a carotid-jugular fistula that resulted in an unprecedented complication, as well as a brief review of the condition’s diagnosis and treatment options. Conclusion: This case report suggests us that, penetrating neck injuries should be thoroughly evaluated for arteriovenous fistulae. To avoid complications, common carotid-jugular fistulas must be treated as soon as possible. Postoperative complications can be effectively managed with prompt action.

Manejo endovascular de una fístula carótido-yugular postraumática

“…El diagnóstico de las FAV es principalmente clínico, se sospecha con presencia de thrill, edema o signos de alto gasto 8 . La confirmación diagnóstica se puede A B realizar con ecografía Doppler cervical, la cual es no invasiva y accesible 2,7 , sin embargo los estudios de elección son la angiografía por resonancia magnética o por tomografía computarizada, que permiten conocer la ubicación precisa y el tamaño de la fístula antes de la intervención quirúrgica 2,6 . El manejo de las FAV cervicales no se debe retrasar debido al desarrollo de fibrosis y de circulación colateral que aumenta el riesgo de sangrado operatorio 5 .…”

“…Las fístulas carótido-yugulares representan el 4% de las FAV traumáticas 5 . Su principal causa son los traumas cortopunzantes seguidos de las lesiones por arma de fuego 6 ; en los últimos años, las lesiones iatrogénicas han tomado un papel importante en esta patología. Por la forma de presentación, usualmente su diagnóstico no se realiza en la fase aguda y son tratadas semanas a meses posteriores al trauma índice 7 .…”

External Carotid Artery-Jugular Vein Fistula Caused by Blunt Trauma: A Case Report & Literature Review

“…Ligation of the internal carotid artery was also mentioned in the literature in a case that presented with pseudoaneurysm and AVF. 7 The great saphenous vein (GSV) can be used as a graft with low risks of infection and thrombosis. 26 However, harvesting the GSV results in longer operative time and an additional incision.…”

Synchronous Carotid Body and Glomus Jugulare Tumors : A Case Report and Review of Literature

“…Paraganglioma may occur in two patterns : 1) familial : non multicentric up-to 50% and 2) nonfamilial : multicentric 5% 26) . These tumors usually possess secretory granules (even the functionally inactive tumors) and may actively secrete catecholamines (similar to pheochromocytomas, occur in only 1-4% of gastro jejunal tumor) 12,13) .…”

“…Other possible complication include aspiration, delayed gastric emptying, ileus and excessive blood loss. Even after gross total tumor removal, recurrence rate may be as high as one third 12) .…”