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Delayed rupture of a posttraumatic retromaxillary pseudoaneurysm causing massive bleeding: a case report
Jae Ha Hwang1, Woo Hyeong Kim1, Jun Ho Choi1
1Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea.
Archives of Craniofacial Surgery
|July 5, 2021
Summary
A rare case of facial pseudoaneurysm rupture after zygomaticomaxillary fracture surgery led to severe bleeding. Early contrast-enhanced CT is crucial for diagnosing potential pseudoaneurysms in severe facial fractures.
Area of Science:
- Trauma surgery
- Vascular surgery
- Radiology
Background:
- Posttraumatic pseudoaneurysms, though rare, pose a significant risk of life-threatening hemorrhage.
- Facial trauma, including zygomaticomaxillary complex fractures, can lead to these vascular complications.
Observation:
- A patient with a comminuted zygomaticomaxillary fracture developed a retromaxillary pseudoaneurysm postoperatively.
- The pseudoaneurysm was unexpectedly discovered via contrast-enhanced CT during evaluation for a wound infection.
Findings:
- The pseudoaneurysm ruptured, causing massive oral bleeding originating from the posterior superior alveolar artery.
- Endoscopic management achieved hemostasis by packing the maxillary sinus.
Implications:
- This case highlights the importance of considering pseudoaneurysm in patients with severe zygomaticomaxillary fractures, especially with delayed complications.
- Contrast-enhanced CT is recommended for evaluating potential pseudoaneurysms in such high-risk cases to prevent catastrophic bleeding.
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