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This is a case presentation.
Objective - In this discussion our intent is to review the etiologies of carotid artery pseudoaneurysm, and to discuss methods of treatment.
Methods - Our particular case was managed with careful preoperative evaluation of the imaging and then surgical exploration. Repair of the vessel after isolation and debridement with GSV patch angioplasty. Upon completion, intraoperative patency was confirmed with duplex ultrasonography.
Results - The patient's initial complaint on presentation to the ED at the outside facility was that of upper airway compression. The patient was initially admitted after non contrast ct of the neck with a diagnosis of retropharyngeal abscess. It was only on subsequent imaging with IV contrast that the pseudoaneurysm was able to be identified definitively.Favorable outcome, no neurologic deficits or recurrence of pseudoaneurysm in ths particular patient at 1 year follow. up.
Conclusions - In this particular case, the presentation was atypical in timing, as the only possible identifiable trauma was three weeks previous, and it did not seem remarkable to the patient. It took extensive questioning and then the patient recalled a possible mechanism of trauma. Physical exam was also atypical as there was no pulsatility to the mass.
A high index of suspicion must be maintained in the diagnosis of a cervical mass particularly when in the anterior cervical triangle.