CAROTID-JUGULAR FISTULA FOLLOWING A BOMB EXPLOSION: A CASE STUDY OF RARE FISTULA

Nabeel Y. Al-Madwahi; Khulood Ebrahim Al-Dailami; Khaled Abdulkarim Al-Moyed; Emad Hassan Al-Shamahi; Hassan Abdulwahab Al-Shamahy; Omar Ahmed Ismael Al-dossary

doi:10.22270/ujpr.v10i1.1279

Nabeel Y. Al-Madwahi Department of Vascular Surgery, Faculty of Medicine and Health Science, Sana’a University, Sana’a, Yemen.
Khulood Ebrahim Al-Dailami Department of Vascular Surgery, Al Jumhouri Modern General Hospital, Sana'a City, Yemen.
Khaled Abdulkarim Al-Moyed Medical Microbiology Department, Faculty of Medicine and Health Sciences, Sana’a University, Republic of Yemen.
Emad Hassan Al-Shamahi Opthalmology Department, Faculty of Medicine and Health Sciences, Sana’a University, Republic of Yemen.
Hassan Abdulwahab Al-Shamahy Department of Vascular Surgery, Faculty of Medicine and Health Science, Sana’a University, Sana’a, Yemen. Medical Microbiology Department, Faculty of Medicine and Health Sciences, Sana’a University, Republic of Yemen.
Omar Ahmed Ismael Al-dossary Faculty of Dentistry, 21 September University, Republic of Yemen.

10.22270/ujpr.v10i1.1279

Keywords:

Common carotid artery (CCA), Internal jugular vein (IJV), Carotid-Jugular Fistula (CJF), CT Angiogram

Abstract

Background: Traumatic arteriovenous fistula (TAVF) is a rare vascular injury, usually caused by blast trauma and is on the rise in Yemen due to the ongoing war there for 14 years. This report describes a case of TAVF that occurred 5 days before the patient sought help and presented to the hospital.

Case presentation: A 16-year-old male with unknown past medical history presented five days after a bomb blast with penetrating trauma to the second zone of the neck. Physical examination revealed a tremor over the site of injury, suggestive of vascular injury, but the patient had no active bleeding, neurologic deficit, or expansive hematoma. Computed tomography (CT) angiography findings were critical in confirming a traumatic arteriovenous fistula and guiding the surgical approach for exploration and repair. Surgical exploration identified a carotid-jugular fistula between the posterolateral common carotid artery and the medial internal jugular vein. Computed tomography angiography findings confirmed successful closure of the fistula with preservation of vascular integrity and no immediate postoperative complications.

Conclusion: This case report describes the successful surgical management of a rare carotid-jugular fistula after a bomb blast. The positive outcomes, including preservation of neurological function and vascular integrity, highlight the importance of prompt surgical intervention and the potential for excellent recovery in traumatic vascular injuries.