Key messages
On a pseudoaneurysm of the superior thyroid artery as “very rare cause of throat swelling” Dr. Jiri Podzimek and colleagues from the Bad Salzungen Hospital. Such a pseudoaneurysm is dangerous because it can rupture. This can have fatal consequences, such as obstruction of the airways, Podzimek and his colleagues explain.The reason for the warning is the medical history of a 55-year-old woman.
The patient and her history
According to the authors, the patient came because a painful swelling of the right cervical and suspicion of a thyroid cyst with blood to the thyroid outpatient clinic of the clinic in Bad Salzungen. There she had reported that she had choked three days earlier and coughed very strongly; During the cough, there was a severe pain in the larynx to the right of the thyroid cartilage. The pain initially subsided, “but came back after 1-2 days, and there was also a small but palpable swelling in the area.” Background: In 2010, a left hemithyroidectomy and a resection of the caudal right thyroid pole were performed.
Findings and diagnosis
At the level of the thyroid cartilage on the right “coarse, pressure-dolent, non-movable mass” (diameter about 1.5 cm) palpable
No redness and overheating of the skin
No elevated inflammatory parameters
B-mode sonography: predominantly anechoic, oval, approx.1 cm cranial mass of the right upper thyroid pole
Color-coded duplex ultrasonography: central arterial vessel within the anechoic mass, trace from the external carotid artery to the upper right thyroid pole
computed tomography (CT) with contrast agent: confirmation of the Suspected diagnosis of “vascular pathology of the superior thyroid artery”; Visible dilation of the vascular lumen with contrast agent leakage into the paravasal space
Diagnosis: painful pseudoaneurysm of the superior thyroid artery
Postoperative Progression without complications and therefore discharge of the patient from the clinic
Ultrasonography after three weeks: complete occlusion of the vessel
Discussion
A true aneurysm of the A.Thyroidea superior is very rare, according to the authors. The case described here was a pseudoaneurysm of that vessel. This leads to perforation of the vessel wall and hematoma formation in the extravascular space with connective tissue organization. A vasodilation is therefore only feigned.
Causes of a pseudoaneurysm described in the literature are, for example, injuries during thyroid puncture, after radiofrequency ablation of a parathyroid adenoma, during radiation of a hypopharyngeal carcinoma or as a result of trauma.
In the present case, the genesis of the pseudoaneurysm is unclear. The only event that the patient remembered was the “onset of symptoms immediately following a severe coughing event”. The earlier thyroid operation did not play a role in this context, as the upper pole on the right had not been touched at the time.
Any pseudoaneurysm in the neck area can lead to life-threatening conditions, because in the event of a rupture, in addition to acute blood loss, obstruction of the upper airways is possible, Podzimek and his colleagues conclude.A safe and low-complication therapy option for small pseudoaneurysms is endovascular coiling.
A very rare, but also dangerous pseudoaneurysm has recently been reported by orthopaedic surgeons and surgeons in Leipzig. This case involved a patient with
Very rare, but not “impossible”, are
Postoperative Progression without complications and therefore discharge of the patient from the clinic
Ultrasonography after three weeks: complete occlusion of the vessel
Discussion
A true aneurysm of the A.Thyroidea superior is very rare, according to the authors. The case described here was a pseudoaneurysm of that vessel. This leads to perforation of the vessel wall and hematoma formation in the extravascular space with connective tissue organization. A vasodilation is therefore only feigned.
Causes of a pseudoaneurysm described in the literature are, for example, injuries during thyroid puncture, after radiofrequency ablation of a parathyroid adenoma, during radiation of a hypopharyngeal carcinoma or as a result of trauma.
In the present case, the genesis of the pseudoaneurysm is unclear. The only event that the patient remembered was the “onset of symptoms immediately following a severe coughing event”. The earlier thyroid operation did not play a role in this context, as the upper pole on the right had not been touched at the time.
Any pseudoaneurysm in the neck area can lead to life-threatening conditions, because in the event of a rupture, in addition to acute blood loss, obstruction of the upper airways is possible, Podzimek and his colleagues conclude.A safe and low-complication therapy option for small pseudoaneurysms is endovascular coiling.
A very rare, but also dangerous pseudoaneurysm has recently been reported by orthopaedic surgeons and surgeons in Leipzig. This case involved a patient with
Very rare, but not “impossible”, are
Sorry, this full text is reserved for
You have reached the maximum number of articles for unregistered visitors
Source – https://www.univadis.de/viewarticle/frau-einer-schmerzhaften-schwellung-am-hals-2024a10003be