Venous bypass for decompression of bleeding varices of the pharynx

Bilateral radical neck dissection results in major morbidity when both jugular veins are ligated. Reported complications include massive facial edema, airway obstruction, and increased intracranial pressure. We describe a case in which a previously unreported complication of bleeding pharyngeal varices was encountered. The problem was successfully managed by decompressing the neck veins with a venous bypass using a transposition of the cephalic vein.