Cargando…
Active upper aerodigestive tract hemorrhage in patients with head and neck cancers: the “dot-in-sludge” sign
Active extravasation into the upper aerodigestive tract is a dramatic and potentially life-threatening complication in patients with head and neck cancers. It prompts presentation to the emergency room and subsequent urgent imaging to identify the source of hemorrhage. Imaging of these patients may...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10063472/ https://www.ncbi.nlm.nih.gov/pubmed/36807208 http://dx.doi.org/10.1007/s10140-023-02118-9 |
_version_ | 1785017713587912704 |
---|---|
author | Goswami, Abhishek Fisicaro, Ryan A. Howard, Brian M. Patel, Milind Aiken, Ashley H. Baugnon, Kristen L. Wu, Xin |
author_facet | Goswami, Abhishek Fisicaro, Ryan A. Howard, Brian M. Patel, Milind Aiken, Ashley H. Baugnon, Kristen L. Wu, Xin |
author_sort | Goswami, Abhishek |
collection | PubMed |
description | Active extravasation into the upper aerodigestive tract is a dramatic and potentially life-threatening complication in patients with head and neck cancers. It prompts presentation to the emergency room and subsequent urgent imaging to identify the source of hemorrhage. Imaging of these patients may be complicated by treatment-altered anatomy, posing a challenge to the emergency radiologist who needs to rapidly identify the presence of active hemorrhage and the potential source vessel. This retrospective review summarizes the clinical and imaging findings of 6 oropharyngeal and oral cavity squamous cell cancer (SCC) patients with active upper aerodigestive tract hemorrhage. Most patients had advanced stage disease and prior radiation therapy. All CECT or CTA exams on presentation demonstrated the “dot-in-sludge” sign of active extravasation, as demonstrated by a “dot” of avidly enhancing extravasated contrast material layered against a background “sludge” of non-enhancing debris in the lumen of the upper aerodigestive tract. Common sources of hemorrhage included the lingual, facial, and superior thyroidal arteries. Familiarity with these findings will help radiologists increase their accuracy and confidence in interpreting these urgent, complex examinations. |
format | Online Article Text |
id | pubmed-10063472 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-100634722023-04-01 Active upper aerodigestive tract hemorrhage in patients with head and neck cancers: the “dot-in-sludge” sign Goswami, Abhishek Fisicaro, Ryan A. Howard, Brian M. Patel, Milind Aiken, Ashley H. Baugnon, Kristen L. Wu, Xin Emerg Radiol Pictorial Essay Active extravasation into the upper aerodigestive tract is a dramatic and potentially life-threatening complication in patients with head and neck cancers. It prompts presentation to the emergency room and subsequent urgent imaging to identify the source of hemorrhage. Imaging of these patients may be complicated by treatment-altered anatomy, posing a challenge to the emergency radiologist who needs to rapidly identify the presence of active hemorrhage and the potential source vessel. This retrospective review summarizes the clinical and imaging findings of 6 oropharyngeal and oral cavity squamous cell cancer (SCC) patients with active upper aerodigestive tract hemorrhage. Most patients had advanced stage disease and prior radiation therapy. All CECT or CTA exams on presentation demonstrated the “dot-in-sludge” sign of active extravasation, as demonstrated by a “dot” of avidly enhancing extravasated contrast material layered against a background “sludge” of non-enhancing debris in the lumen of the upper aerodigestive tract. Common sources of hemorrhage included the lingual, facial, and superior thyroidal arteries. Familiarity with these findings will help radiologists increase their accuracy and confidence in interpreting these urgent, complex examinations. Springer International Publishing 2023-02-18 2023 /pmc/articles/PMC10063472/ /pubmed/36807208 http://dx.doi.org/10.1007/s10140-023-02118-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Pictorial Essay Goswami, Abhishek Fisicaro, Ryan A. Howard, Brian M. Patel, Milind Aiken, Ashley H. Baugnon, Kristen L. Wu, Xin Active upper aerodigestive tract hemorrhage in patients with head and neck cancers: the “dot-in-sludge” sign |
title | Active upper aerodigestive tract hemorrhage in patients with head and neck cancers: the “dot-in-sludge” sign |
title_full | Active upper aerodigestive tract hemorrhage in patients with head and neck cancers: the “dot-in-sludge” sign |
title_fullStr | Active upper aerodigestive tract hemorrhage in patients with head and neck cancers: the “dot-in-sludge” sign |
title_full_unstemmed | Active upper aerodigestive tract hemorrhage in patients with head and neck cancers: the “dot-in-sludge” sign |
title_short | Active upper aerodigestive tract hemorrhage in patients with head and neck cancers: the “dot-in-sludge” sign |
title_sort | active upper aerodigestive tract hemorrhage in patients with head and neck cancers: the “dot-in-sludge” sign |
topic | Pictorial Essay |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10063472/ https://www.ncbi.nlm.nih.gov/pubmed/36807208 http://dx.doi.org/10.1007/s10140-023-02118-9 |
work_keys_str_mv | AT goswamiabhishek activeupperaerodigestivetracthemorrhageinpatientswithheadandneckcancersthedotinsludgesign AT fisicaroryana activeupperaerodigestivetracthemorrhageinpatientswithheadandneckcancersthedotinsludgesign AT howardbrianm activeupperaerodigestivetracthemorrhageinpatientswithheadandneckcancersthedotinsludgesign AT patelmilind activeupperaerodigestivetracthemorrhageinpatientswithheadandneckcancersthedotinsludgesign AT aikenashleyh activeupperaerodigestivetracthemorrhageinpatientswithheadandneckcancersthedotinsludgesign AT baugnonkristenl activeupperaerodigestivetracthemorrhageinpatientswithheadandneckcancersthedotinsludgesign AT wuxin activeupperaerodigestivetracthemorrhageinpatientswithheadandneckcancersthedotinsludgesign |