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Thorium-dioxide--induced pharyngeal hemorrhage
American Journal of Otolaryngology
|November 1, 1983
Summary
Thorium dioxide angiography complications can cause severe pharyngeal hemorrhage, even with occluded carotid arteries. This rare but life-threatening condition may necessitate extensive surgery for hemostasis.
Area of Science:
- Radiology
- Vascular Surgery
- Oncology
Background:
- Thorium dioxide was used for angiography from 1930-1950.
- Cervical thorium dioxide granuloma is a known complication of extravasation.
- Radical neck dissection poses hemorrhage risk due to radiation-weakened carotid arteries.
Observation:
- Hemorrhage can occur spontaneously due to pharyngeal necrosis or post-biopsy infection.
- Life-threatening pharyngeal hemorrhage can arise from thorium dioxide, even with an occluded carotid system.
- Bleeding sites may be difficult to identify, potentially requiring laryngopharyngectomy.
Findings:
- Infection can extend to the retroesophageal space and thoracic inlet.
- Exteriorization of neck wounds is crucial to protect mediastinal great vessels.
- Thorium dioxide-induced necrosis can lead to spontaneous aortic rupture.
Implications:
- Highlights the delayed, severe vascular complications of thorium dioxide.
- Emphasizes the need for vigilance in patients with prior thorium dioxide exposure.
- Informs surgical management strategies for rare but critical post-angiography complications.