Pseudoaneurysm of the proximal facial artery presenting as oropharyngeal hemorrhage

Background. Penetrating trauma to the neck traversing zones II and III may cause considerable damage to soft tissues and neurovascular structures. Del ayed sequelae of vascular injuries, such as pseudoaneurysm (PA), may presen t weeks to months after the initial injury. Methods. We report an unusual case of a traumatic PA of the proximal facial artery that ruptured into the oropharynx. Results. A 30-year-old man presented with oropharyngeal hemorrhage one mont h after a gunshot wound to the neck. Angiography revealed a PA of the proxi mal facial artery, which was treated with embolization. The arterial injury leading to the pseudoaneurysm had not been detected by arteriography at th e time. Conclusions. PAs are rare complications of penetrating neck trauma. To our knowledge, this is only the second report of PA involving the proximal faci al artery, and the first of a facial PA rupture into the pharynx. (C) 2001 John Wiley & Sons, Inc.