PMC5869802_01
Right neck wound with intermittent bleeding
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F1
The bleeding eventually stopped, but suddenly occurred again the night of her arrival to our hospital [Figure 1].
Computed tomography angiograph showing partially thrombosed pseudoaneurysm with tract containing gas and fluid extending to the skin surface
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F2
Her vital signs were normal and her hemoglobin was 11.5 on arrival and hence, we ordered a CT angiograph (CTA)-head-and-neck with showed a partially thrombosed PA in the region of her right common carotid artery bifurcation with a tract containing gas and fluid extending to the skin surface suspicious for a partially thrombosed, leaking PA [Figure 2].
Explanation of a chronically infected polyethylene terephthalate patch and a probe traversing a right carotid-cutaneous fistula
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F3
She was taken urgently to the operating room on broad spectrum antibiotics where we performed a right neck exploration, ligation of a bleeding carotid PA by ligation of the right common, internal, and external carotid arteries, explantation of a chronically infected polyethylene terephthalate patch, and closure with a sternocleidomastoid advanced flap with multilayered closure [Figure 3].