Spontaneous rupture of the common carotid artery is an extremely rare disor
der. Presentation in an elderly gentleman as a widened mediastinum with car
diac compromise has not been previously reported. Emergency surgical explor
ation to decompress the airway revealed a 5-mm rear just proximal to the le
ft common carotid artery bifurcation and a large para-oesophageal haematoma
. The case is reviewed and the possible causes discussed. (C) 1999 Elsevier
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