TY - JOUR
T1 - Carotid Blowout Syndrome in the Emergency Department
T2 - A Case Report and Review of the Literature
AU - Lipe, Demis N.
AU - Viets-Upchurch, Jayne
AU - Hanna, Ehab Y.
AU - Reyes-Gibby, Cielito
AU - Chen, Stephen R.
AU - Elsayem, Ahmed
AU - Long, Brit
N1 - Publisher Copyright:
© 2021
PY - 2022/3
Y1 - 2022/3
N2 - Background: Carotid blowout syndrome (CBS) is an infrequent but dangerous oncologic emergency that must be recognized due to a mortality rate that approaches 40% and neurologic morbidity that approaches 60%. Patients present with a variety of symptoms ranging from asymptomatic to frank hemorrhage, and appropriate recognition and management may improve their outcomes. Case Report: A man in his late 60s with squamous cell carcinoma of the oropharynx presented to the emergency department (ED) with hemoptysis and several episodes of post-tussive emesis with large clots. He had been cancer free for multiple years after treatment with chemotherapy and radiation to the neck. Evaluation revealed a necrotic tumor on the posterior pharynx on bedside laryngoscopy and an external carotid pseudoaneurysm that was stented by interventional radiology. The patient experienced recurrent hemorrhage several months later and opted for palliative measures and expired of massive hemorrhage in the ED on a subsequent visit. Why Should an Emergency Physician Be Aware of This?: CBS can be fatal, and early suspicion and recognition are key to ensure that a threatened or impending carotid blowout are appropriately managed. Once carotid blowout is suspected, early resuscitation and consultation with interventional radiology and vascular surgery is warranted.
AB - Background: Carotid blowout syndrome (CBS) is an infrequent but dangerous oncologic emergency that must be recognized due to a mortality rate that approaches 40% and neurologic morbidity that approaches 60%. Patients present with a variety of symptoms ranging from asymptomatic to frank hemorrhage, and appropriate recognition and management may improve their outcomes. Case Report: A man in his late 60s with squamous cell carcinoma of the oropharynx presented to the emergency department (ED) with hemoptysis and several episodes of post-tussive emesis with large clots. He had been cancer free for multiple years after treatment with chemotherapy and radiation to the neck. Evaluation revealed a necrotic tumor on the posterior pharynx on bedside laryngoscopy and an external carotid pseudoaneurysm that was stented by interventional radiology. The patient experienced recurrent hemorrhage several months later and opted for palliative measures and expired of massive hemorrhage in the ED on a subsequent visit. Why Should an Emergency Physician Be Aware of This?: CBS can be fatal, and early suspicion and recognition are key to ensure that a threatened or impending carotid blowout are appropriately managed. Once carotid blowout is suspected, early resuscitation and consultation with interventional radiology and vascular surgery is warranted.
KW - carotid blowout syndrome
KW - case report
KW - emergency department
KW - impending carotid blowout
KW - threatened carotid blowout
UR - http://www.scopus.com/inward/record.url?scp=85123091150&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85123091150&partnerID=8YFLogxK
U2 - 10.1016/j.jemermed.2021.11.009
DO - 10.1016/j.jemermed.2021.11.009
M3 - Article
C2 - 35065858
AN - SCOPUS:85123091150
SN - 0736-4679
VL - 62
SP - e29-e34
JO - Journal of Emergency Medicine
JF - Journal of Emergency Medicine
IS - 3
ER -