Pseudoaneurysm following “routine” third molar extraction: a case report and review of the literature

Abstract

Pseudoaneurysms are rare, life-threatening vascular lesions caused by damage to an arterial wall and have a high propensity for rupture and hemorrhage. The aim of this case report is to discuss the evaluation, diagnosis, and management of unusual bleeding following dental extractions in an otherwise healthy 17-year-old female. She presented post-operatively with facial swelling and bruising following outpatient extraction of third molars. Exploration of the surgical site revealed active bleeding that was unresponsive to pressure and application of hemostatic agents. Selective embolization was performed after a pseudoaneurysm of the inferior alveolar artery was identified, resulting in no further bleeding and return to baseline diet and activity. Any practitioner performing dental extractions who encounters unusual bleeding should be aware of this potentially fatal vascular lesion and its relevant treatment options. While surgical ligation is technically feasible, minimally invasive intravascular interventions provide a safe and effective method for management of this complication.

Keywords

• Dentoalveolar surgery
• Dental extraction complications
• Post-operative bleeding
• Pseudoaneurysm
• Embolization
• Third molars