A Giant Pseudoaneurysm Mimicking Retropharyngeal Abscess in a Child

Area of Science:

• Vascular Surgery
• Pediatric Radiology
• Interventional Neuroradiology

Background:

• Cervical internal carotid artery pseudoaneurysms are rare vascular lesions.
• They pose a significant risk of life-threatening hemorrhage.
• Management requires prompt and precise intervention.

Observation:

• A child presented with symptoms mimicking a neck abscess, including fever, neck swelling, dysphagia, and respiratory distress.
• Airway compromise prevented intubation due to a retropharyngeal bulge.
• Initial clinical suspicion of abscess was revised based on imaging.

Findings:

• Diagnostic imaging revealed a pseudoaneurysm of the cervical internal carotid artery, not a neck abscess.
• Endovascular treatment, including stent placement and coiling, was successfully employed.
• This approach avoided surgical incision and drainage, mitigating risks.

Implications:

• Highlights the importance of considering pseudoaneurysms in pediatric neck masses with airway compromise.
• Emphasizes the critical role of advanced imaging in accurate diagnosis.
• Demonstrates the efficacy of endovascular techniques in managing pediatric cervical pseudoaneurysms, reducing morbidity.