Chaudhary Ravi, Jain Gaurav, Arjunan Deepak Kumar, Bhattarai Ananda
Department of Anaesthesiology, AIIMS, Rishikesh, Uttarakhand, India.
Saudi J Anaesth. 2024 Oct-Dec;18(4):596-598. doi: 10.4103/sja.sja_320_24. Epub 2024 Oct 2.
Arteriovenous malformation (AVM) of the head and neck, though rare, can present significant clinical challenges, particularly during dental procedures. This case report details the acute management of a 7-year-old girl with an AVM in the right mandible, with sudden, severe, torrential intraoral hemorrhage during an angioembolization procedure, necessitating immediate airway management and hemodynamic stabilization in a nonoperating room anesthesia (NORA) setting. Persistent bleeding led to a multidisciplinary intervention, including external carotid artery ligation and right hemimandibulectomy, achieving hemostasis. The case underscores the importance of meticulous planning, readiness with resuscitation and airway management equipment, and coordinated efforts among anesthesia and surgical teams in NORA settings to manage such critical situations effectively.
头颈部动静脉畸形(AVM)虽罕见,但会带来重大临床挑战,尤其是在牙科手术期间。本病例报告详细介绍了一名7岁右下颌骨患有AVM的女孩的急性处理情况,在血管栓塞手术期间突然发生严重的口腔内大出血,需要在非手术室麻醉(NORA)环境中立即进行气道管理和血流动力学稳定处理。持续出血导致了多学科干预,包括结扎颈外动脉和右半侧下颌骨切除术,从而实现了止血。该病例强调了在NORA环境中精心规划、准备好复苏和气道管理设备,以及麻醉和手术团队协同努力以有效处理此类危急情况的重要性。