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Early presentation of traumatic pseudoaneurysm of deep lingual artery as a massive oral bleed

Abstract

Tongue trauma with active bleed is most commonly due to the ruptured lingual artery and its branches, whereas delayed haemorrhage is usually secondary to pseudoaneurysm formation. This case is a unique presentation of traumatic tongue bleeds with early formation of pseudoaneurysm of a lingual artery branch. We present our experience in its management. A contrast-enhanced CT (CECT) with angiography detected right deep lingual artery pseudoaneurysm, which was managed by endovascular gelfoam embolisation followed by tongue laceration repair. Tongue bleed stopped immediately post embolisation; tongue viability and functions restored on postoperative day 1 of repair. No complications like secondary haemorrhage or tongue necrosis were noted at 1-month follow-up. High index of suspicion for lingual artery and/or its branch pseudoaneurysm is crucial in acute and uncontrollable traumatic tongue bleed. A CECT is a minimum norm in early diagnosis. Choice of management is the cornerstone of a successful outcome.

  • otolaryngology / ENT
  • interventional radiology
  • trauma

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