Abstract
We report two cases of carotid blowout syndrome. The first case, a 38-year-old man, suffered from common carotid artery rupture due to postoperative infection after thyroid surgery, and visited our emergency room. The site of rupture was identified under angiography, and was occluded with a balloon catheter. Then, carotid ligation was performed and the surgical site was covered with a deltopectoral skin flap. The second case, a 55-year-old woman, had undergone neck dissection and Co60 irradiation for oral tongue cancer 30 years before. Subsequently, she developed a cervical fistula, and suffered a hemorrhage from the fistula. Pseudoaneurysm of the external carotid artery was found by CT, so we tried to perform coil embolization, but could not control the bleeding. Thereafter, we confirmed necrosis around the carotid bifurcation, ligated the common carotid artery, and covered the surgical site with a pectoralis major myocutaneous flap. The triggers of both ruptures were inflammation, and, fortunately, ligating the carotid artery enabled both cases to survive without cerebrovascular disorder.
