Isolated Blunt Lingual Artery Injury Secondary to a Road Traffic Accident: Diagnostic and Therapeutic Approach

Neurologic and airway compromise as a result of traumatic vascular injuries to the neck region often lead to more severe complications and thus require special consideration. Furthermore, these cases pose diagnostic and therapeutic challenges to healthcare providers. Here, we report a case of a 28-year-old motorcyclist presenting with progressively enlarged Zone 2 neck swelling on the left side following a high impact collision. There were no symptoms or signs suggesting neurologic or laryngeal injury. Computed tomography angiogram of the neck revealed signs of an active arterial bleed. The apparent vascular injury was managed by close observation for signs of airway compromise, urgent angiogram, and selective catheter embolisation of the left lingual artery. The patient subsequently recovered without further operative exploration of the neck. At 6 months post-trauma, the neck swelling fully subsided with no complications from angioembolisation. This case illustrates the individualised treatment and multidisciplinary approach in managing such cases. We review our rationale for this diagnostic and therapeutic approach.

Common Iliac Vessel Injury after Lumbar Discectomy

Injury of common iliac vein related to lumbar discectomy is a rare complication. We report a patient who sustained injury of common iliac vein during lumbar discectomy for extraforaminal lumbar herniated disc. In this case, she had hypovolemic shock due to massive bleeding, and underwent emergent interventional treatment and open laparatomy. Although the vascular injuries were successfully repaired, it could be a fatal complication. We report the clinical features and early management, emphasizing the need for rapid diagnosis, immediate intervention and treatment for favorable outcome.