A Rare Occurrence of Acute Carotid Blowout Syndrome in Saudi Arabia

An unfortunate and feared complication of oncologic head-and-neck surgery is acute carotid blowout syndrome (ACBS). We present a rare case of ACBS in a patient who underwent salvage total laryngectomy after treatment with organ-sparing radiochemotherapy. A 62-year-old male with a history of glottic squamous cell carcinoma presented with massive transoral and transnasal bleeding 5 weeks following total salvage laryngectomy. Computed tomography angiography showed aneurysmal bleeding from the right common carotid artery. The active oral and nasal bleeding presentations were not provided with external warning signs of its forthcoming existence. The patient underwent emergent right carotid stenting by an interventional radiologist. Hemostasis was achieved without any neurological deficits. Carotid blowout syndrome prevention by early identification of the risk factors is necessary to prevent fatal hemorrhage or grave neurological morbidity. Early intervention to control bleeding results in significantly lower morbidity and mortality rates.