Large volume haemorrhage following transoral robotic surgery (TORS) as a result of fibromuscular dysplasia: first reported case

We present a case of a 61-year-old woman who suffered a haemorrhagic complication of an aneurysmal left lingual artery, secondary to fibromuscular dysplasia, following transoral robotic surgery (TORS). She was admitted through the emergency department 3 days after resection of a central base of tong...

Full description

Saved in:
Bibliographic Details
Published in:BMJ case reports 2019-11, Vol.12 (11), p.e232022
Main Authors: Leedman, Samuel Robert, Esmaili, Aaron, Singh, Tejinder, Wee, Desmond
Format: Article
Language:English
Subjects:
Antibiotics
Arteriovenous Fistula - etiology
Carotid arteries
Case reports
Ears & hearing
Family medical history
Female
Fibromuscular Dysplasia - etiology
Hemoglobin
Hospitals
Humans
Hypertension
Intensive care
Medical imaging
Middle Aged
Mouth Floor - blood supply
Postoperative Hemorrhage - etiology
Rare Disease
Robotic surgery
Robotic Surgical Procedures - adverse effects
Robotic Surgical Procedures - methods
Surgeons
Surgery
Tongue Neoplasms - surgery
Veins & arteries
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We present a case of a 61-year-old woman who suffered a haemorrhagic complication of an aneurysmal left lingual artery, secondary to fibromuscular dysplasia, following transoral robotic surgery (TORS). She was admitted through the emergency department 3 days after resection of a central base of tongue tumour. She suffered a massive haemorrhage requiring intensive care admission, blood transfusion, intubation, operative and endovascular intervention. The diagnosis of fibromuscular dysplasia was made at angiography. During attempts to embolise the culprit left lingual artery, the vessel dissected at its origin leading to arrest of bleeding. Repeat angiograms during her admission demonstrated unchanged appearances and ruled out recanalisation of the vessel. She was extubated and remained stable on the ward, discharged home some days later in good health. To our knowledge, this is the first ever reported case of fibromuscular dysplasia affecting the lingual artery leading to aneurysmal dilation and severe haemorrhage following TORS.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2019-232022