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A Giant Pseudoaneurysm Mimicking Retropharyngeal Abscess in a Child

Gupta, Rijuneeta MS^*; Patro, Sourabha K. MS, DNB, MNAMS^*†; Chauhan, Neha MS^*; Kumar, Ajay MD^‡

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Pediatric Emergency Care: May 2019 - Volume 35 - Issue 5 - p e79-e83

doi: 10.1097/PEC.0000000000001100

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Abstract

Pseudoaneurysms of the cervical internal carotid artery are rare and usually result from trauma, infection, or rarely spontaneously. They harbor potential risk of life-threatening hemorrhage and warrant immediate management. Endovascular treatment in the form of stent placement and coiling is a well established technique for dealing with both intracranial and extracranial pseudoaneurysms. We present a case of a child who presented with fever, neck swelling, dysphagia, and respiratory distress in emergency for which clinical diagnosis of a neck abscess was made. Intubation was not possible because of bulge in the retropharyngeal wall. An elective tracheotomy was planned with imaging of the neck. Imaging and careful planning to avoid incision and drainage in the initial presentation led us to diagnose a pseudoaneurysm and successful management. We present this case to highlight the importance of early recognition and timely meticulous management to avoid serious complications and morbidity in a child.