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A Giant Pseudoaneurysm Mimicking Retropharyngeal Abscess in a Child

Gupta, Rijuneeta, MS*; Patro, Sourabha K., MS, DNB, MNAMS*†; Chauhan, Neha, MS*; Kumar, Ajay, MD

doi: 10.1097/PEC.0000000000001100
Illustrative Cases
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Pseudoaneurysms of the cervical internal carotid artery are rare and usually result from trauma, infection, or rarely spontaneously. They harbor potential risk of life-threatening hemorrhage and warrant immediate management. Endovascular treatment in the form of stent placement and coiling is a well established technique for dealing with both intracranial and extracranial pseudoaneurysms. We present a case of a child who presented with fever, neck swelling, dysphagia, and respiratory distress in emergency for which clinical diagnosis of a neck abscess was made. Intubation was not possible because of bulge in the retropharyngeal wall. An elective tracheotomy was planned with imaging of the neck. Imaging and careful planning to avoid incision and drainage in the initial presentation led us to diagnose a pseudoaneurysm and successful management. We present this case to highlight the importance of early recognition and timely meticulous management to avoid serious complications and morbidity in a child.

From the Departments of *Otolaryngology and Head and Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh;

Otolaryngology and Head and Neck surgery, ANIIMS, Port Blair; and

Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Disclosure: The authors declare no conflict of interest.

Reprints: Rijuneeta Gupta, MS, Department of Otolaryngology, Head and Neck surgery Post Graduate Institute of Medical Education and Research, Chandigarh, India 160012 (e-mail: rijuneeta@yahoo.com).

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