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Delayed endovascular coil extrusion after embolisation for post-tonsillectomy haemorrhage: case report and literature review

Published online by Cambridge University Press:  03 December 2012

W Fassnacht ,
F Hammer ,
Q Gardiner  and
G Desuter
W Fassnacht
Affiliation:
Department of ENT, Head and Neck Surgery, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium, UK
F Hammer
Affiliation:
Department of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium, UK
Q Gardiner
Affiliation:
ENT, Head and Neck Surgery Department, Ninewells Hospital and Medical School, NHS Tayside, University of Dundee, Scotland, UK
G Desuter*
Affiliation:
Department of ENT, Head and Neck Surgery, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium, UK
*
Address for correspondence: Prof G Desuter, ENT, Head and Neck Surgery Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10 Avenue Hippocrate, 1200 Brussels, Belgium E-mail: Gauthier.Desuter@uclouvain.be
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Abstract

Objective:

To report a rare case of delayed endovascular coil extrusion following embolisation of a lingual artery pseudoaneurysm.

Case report:

A 23-year-old woman presented with dysphagia and odynophagia 11 months after having experienced massive post-tonsillectomy haemorrhage. At that time, the bleeding had been stopped by embolisation of a lingual artery pseudoaneurysm and the external carotid artery. Clinical examination at admission showed extrusion of the embolisation coils in the lateral lower pharyngeal wall. The coils were removed under general anaesthesia in the presence of an interventional radiologist. The procedure and post-operative period were without complication and no bleeding was observed. The dysphagia and pain disappeared and the subsequent seven-month follow-up period was uneventful.

Conclusion:

Although selective embolisation is a safe and effective treatment for severe post-tonsillectomy haemorrhage, the possibility of delayed coil extrusion should be kept in mind.

Keywords

TonsillectomyHemorrhagePostoperative ComplicationsTherapeutic EmbolizationPseudoaneurysm

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 1 , January 2013 , pp. 88 - 91
Copyright
Copyright © JLO (1984) Limited 2012

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References

1 Windfuhr, JP, Sesterhenn, AM, Schloendorff, G, Kremer, B. Post-tonsillectomy pseudoaneurysm: an underestimated entity? J Laryngol Otol 2010;124:59–66. Erratum in: J Laryngol Otol 2010;124:66CrossRefGoogle ScholarPubMed
2 van Cruijsen, N, Gravendeel, J, Dikkers, FG. Severe delayed posttonsillectomy haemorrhage due to a pseudoaneurysm of the lingual artery. Eur Arch Otorhinolaryngol 2008;265:115–17Google Scholar
3 McIntosh, DL, Douglas, G, Lee, K, Allen, J, Mahadevan, M. External carotid artery blood supply to the orbit. Int J Pediatr Otorhinolaryngol 2007;71:1623–6Google Scholar
4 Walshe, P, Ramos, E, Low, C, Thomas, L, McWilliams, R, Hone, S. An unusual complication of tonsillectomy. Surgeon 2005;3:296–8Google Scholar
5 Simoni, P, Bello, JA, Kent, B. Pseudoaneurysm of the lingual artery secondary to tonsillectomy treated with selective embolization. Int J Pediatr Otorhinolaryngol 2001;59:125–8Google Scholar
6 Menauer, F, Suckfüll, M, Stäbler, A, Grevers, G. Pseudoaneurysm of the lingual artery after tonsillectomy. A rare complication [German]. Laryngorhinootologie 1999;78:405–7CrossRefGoogle ScholarPubMed
7 Mitchell, RB, Pereira, KD, Lazar, RH, Long, TE, Fournier, NF. Pseudoaneurysm of the right lingual artery: an unusual cause of severe haemorrhage during tonsillectomy. Ear Nose Throat J 1997;76:575–6Google Scholar
8 Lin, HW, Tierney, HT, Richmon, JD, Mark, EJ, Deschler, DG. Extrusion of embolization coils through the carotid artery in a radiated neck. Auris Nasus Larynx 2010;37:390–3Google Scholar
9 Shin, YS, Kim, SY, Moon, SK. Intranasal extrusion of the endovascular coil after occluding internal carotid artery for massive nasopharyngeal bleeding. Otolaryngol Head Neck Surg 2005;133:644Google Scholar
10 Chow, MW, Chan, DT, Boet, R, Poon, WS, Sung, JK, Yu, SC. Extrusion of a coil from the internal carotid artery through the middle ear. Hong Kong Med J 2004;10:215–16Google Scholar
11 Kiyosue, H, Okahara, M, Tanoue, S, Sagara, Y, Matsumoto, S, Mori, H et al. Dispersion of coils after parent-artery occlusion of radiation-induced internal carotid artery pseudoaneurysm. AJNR Am J Neuroradiol 2004;25:1080–2Google Scholar
12 Shah, NA, Akingboye, A, Haldipur, N, Mackinlay, JY, Jacob, G. Embolization coils migrating and being passed per rectum after embolization of a splenic artery pseudoaneurysm, “the migrating coil”: a case report. Cardiovasc Intervent Radiol 2007;30:1259–62Google Scholar
13 Dinter, DJ, Rexin, M, Kaehler, G, Neff, W. Fatal coil migration into the stomach 10 years after endovascular celiac aneurysm repair. J Vasc Interv Radiol 2007;18:s117–20Google Scholar