[Carotico-jugular fistula following a ballistic injury]

Abstract

Carotico-jugular fistulae are known complications of gunshot injuries and stab wounds, but they can be iatrogenic. Untreated, these lesions may lead to heart failure, endocarditis, or cerebral embolization. We present the computerized tomography (CT)-angiographic view and its value in the treatment strategy in carotico-jugular fistula. A 35-year-old male was referred in the second hour of a ballistic injury to the right side of the neck. Physical examination revealed hematoma, exit hole and thrill on the right sternocleidomastoid muscle. Diagnosis was confirmed with Doppler ultrasound and CT angiography. Surgical interposition with 6 mm polytetrafluoroethylene for the carotid artery and with 12 mm Dacron for the internal jugular vein was performed. The fistulous tract was ligated. In the postoperative sixth month, Doppler ultrasound was normal and the patient was on antiaggregant therapy and healthy.