gms | German Medical Science

We present a case of a 83 y.o. male without previous history that presented with a cervical haematoma, initially misdiagnosed as a neck phlegmona. In the course of the diagnostic workup the haematoma enlarged, thereby causing respiratory distress due to upper airway compromise. The endotracheal intubation was lifesaving. Following contrast enhanced CT revealed haematoma in the region of the left common carotid artery. Emergency surgery evacuated the haematoma and repaired what was to be a slit-like defect of the left common carotid 2 cm before the bifurcation. The patient was discharged on the 7^th postoperative day in good condition. We discuss 4 aspects of the case, namely: the rarity of the condition and the variety of causes, the diagnostic and treatment strategy, the unclear reasons for spontaneous ruptures of the carotid, and the operative techniques for haematoma evacuation and definitive haemostasis. The optimal behaviour in cases with cervical haematoma is the following: intubation, diagnosis, surgery.

Key words: neck haematoma, carotid artery, spontaneous rupture.