Internal Maxillary Artery Pseudoaneurysm : A Near Fatal Complication of Seemingly Innocuous Pharyngeal Trauma

Abstract EN

A 2-year-old boy presented with persistent pain and oral blood loss after falling with a toothbrush in his mouth.

Initial routine inspection of the oropharynx showed no abnormalities.

Recurrent blood loss instigated a reinspection under general anesthesia revealing the head of the toothbrush embedded in the nasopharynx.

The toothbrush was removed without problems but several hours later a near fatal rebleeding occurred, requiring aggressive fluid resuscitation.

Subsequently, the patient was transferred to our pediatric intensive care unit for further evaluation and treatment.

CT angiography (CTA) showed a pseudoaneurysm of the internal maxillary artery which was successfully coiled, and further recovery was uneventful.

Pediatric pharyngeal trauma is a common entity with rare, but potentially life-threatening, complications.

In case of pharynx lesions, bleeding, and persistent pain, flexible endoscopy by an otolaryngologist is mandatory.

In case of persistent bleeding vascular imaging is essential with CTA being a reliable alternative for the more invasive angiography.