Common Carotid Artery Pseudoaneurysm: A Perilous Powderkeg

An 11-year-old boy presented with pseudoaneurysm of the common carotid artery, which posed an anaesthetic and surgical challenge. Just prior to the incision, the pseudoaneurysm ruptured necessitating manual compression and emergent endovascular coiling to arrest the bleeding. Appropriate resuscitative steps were undertaken simultaneously, and the coiling was successful thereby saving the patient. Definitive flap reconstruction was later performed. The case report highlights vulnerability of pseudoaneurysms to rupture without warning and causing torrential and life-threatening hemorrhage. The necessity of prior planning and preparation to manage such an emergency should it arise cannot be overemphasized.