Hong Kong Journal of Emergency Medicine

Volume 9 Number 1, January 2002

Case report: life threatening bleeding following maxillofacial injury

KL Tsui, HH Yau, CW Kam

Maxillofacial injury is commonly seen in the practice of emergency medicine. Major maxillofacial injury itself can be life threatening. Apart from the danger of potential airway compromise, severe haemorrhage from branches of carotid artery causing haemorrhagic shock can occur. Blind techniques, such as packing or ligation of external carotid artery are the usual methods employed to stop the bleeding. However blind techniques carry a significant failure rate. A patient with severe maxillofacial injury and torrential haemorrhage is reported. The bleeding could not be controlled by oral and nasal packing. Emergency selective carotid angiography was performed to identify the source of bleeding and embolization of the bleeding branches successfully arrested the haemorrhage. Interventional radiology could be as effective, if not superior, as an operation in controlling bleeding in selective cases. (Hong Kong j.emerg.med. 2002;9:42-45)

Keywords : angiography, carotid artery, embolization, haemorrhage, interventional radiology, maxillofacial injury

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