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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Carotid blowout syndrome caused by chronic infection: A case report
Tian-Hao Xie, Wen-Jun Zhao, Xiao-Long Li, Yan Hou, Xiong Wang, Jing Zhang, Xiu-Hua An, Li-Tao Liu
Tian-Hao Xie, Jing Zhang, Li-Tao Liu, Department of General Surgery, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China
Wen-Jun Zhao, Department of Ophthalmology, MEM Yinghua Hospital, Baoding 071000, Hebei Province, China
Xiao-Long Li, Department of Traumatology, The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
Yan Hou, Department of Imaging, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China
Xiong Wang, Department of General Surgery, Li County Hospital, Baoding 071400, Hebei Province, China
Xiu-Hua An, Department of Internal Medicine, Wangdu County Chinese Medicine Hospital, Baoding 072450, Hebei Province, China
Author contributions: Xie TH and Liu LT contributed to the drafting of the manuscript and the revising the final draft; Zhao WJ, Li XL and Hou Y contributed to the acquisition of data and the revising the final draft; Wang X, Zhang J and An XH contributed to the investigation and interpretation of the descriptive; and All authors have read and approved the manuscript.
Supported by Medical Science Research Project of Hebei Provincial Health Commission, No. 20211642.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Li-Tao Liu, PhD, Professor, Department of General Surgery, Affiliated Hospital of Hebei University, No. 212 East Yuhua Road, Baoding 071000, Hebei Province, China. squall.xth@163.com
Received: December 2, 2021
Peer-review started: December 2, 2021
First decision: December 27, 2021
Revised: February 10, 2022
Accepted: March 26, 2022
Article in press: March 26, 2022
Published online: May 26, 2022
BACKGROUND
Carotid blowout syndrome (CBS) refers to rupture of the extracranial carotid artery and its branches; as a severe complication, it usually occurs after surgery or radiotherapy for malignant tumours of the head and neck. We present a case of CBS caused by chronic infection of the external carotid artery (ECA). In this case, we did not find any evidence of head and neck tumours.
CASE SUMMARY
A 42-year-old man was referred to the Emergency Department with a complaint of a lump found on the left side of his neck with pain and fever for 4 d. We diagnosed the condition as neck infection with abscess formation based on physical examination, routine blood examination, ultrasound examination and plain computed tomography (CT) and decided to perform emergency surgery. During the operation, 30 mL of grey and smelly pus was drained from the deep surface of the sternocleidomastoid muscle. The second day after the operation, the patient suddenly exhibited a large amount of haemoptysis and incision bleeding. The enhanced CT showed distal occlusion of the left ECA and irregular thickening of the broken ends of the artery encased in an uneven enhancement of soft tissue density. Infected ECA occlusion and rupture were considered. The patient was transferred to a vascular unit for transcatheter ECA embolization and recovered well.
CONCLUSION
Surgeons need to pay attention to vascular lesions caused by chronic infection that may develop into acute CBS.
Core Tip: Carotid blowout syndrome (CBS) refers to rupture of the extracranial carotid artery and its branches; as a severe complication, it usually occurs after surgery or radiotherapy for malignant tumours of the head and neck. We present a case of CBS caused by chronic infection of the external carotid artery. In this case, we did not find any evidence of head and neck tumours. This suggested that surgeons need to pay attention to vascular lesions caused by chronic infection that may develop into acute CBS.
