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Journal of Medical Case Reports

, 9:226

First Online: 06 October 2015Received: 05 July 2015Accepted: 15 September 2015DOI: 10.1186-s13256-015-0710-9

Cite this article as: Crosetti, E., Fulcheri, A. & Succo, G. J Med Case Reports 2015 9: 226. doi:10.1186-s13256-015-0710-9


IntroductionWe present a rare case of pharyngo-jugular fistula in a patient who underwent salvage total laryngectomy after organ-sparing radiochemotherapy.

Case presentationA 77-year-old Caucasian man underwent total laryngectomy and bilateral neck dissection as salvage surgery after the failure of radiochemotherapy at another hospital. Thirty-five days after surgery, he was admitted to our emergency room for fever and massive oral bleeding during meals. Videopanendoscopy showed the presence of a large clot at the base of his tongue, while a neck computed tomography scan showed a pharyngo-jugular fistula with the presence of air in the left internal jugular vein. Cervicotomy was performed: the internal jugular vein was ligated and sectioned, and the pharyngeal defect was repaired with a pectoralis major myocutaneous flap. The postoperative period was uneventful. Twenty-five days post surgery, videofluorography showed the fistula had disappeared. Our patient then began oral feeding without complications and was discharged. At present, 5 years after the operation, our patient is alive and shows no evidence of disease.

ConclusionsPharyngo-jugular fistula is an uncommon complication after total laryngectomy, especially in the chemoradiation era, which is potentially fatal if not promptly treated.

KeywordsPharyngo-jugular fistula Fistula Complication after total laryngectomy AbbreviationsBMIBody mass index

CTComputed tomography

IVGInternal jugular vein

RRRelative risk

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Author: Erika Crosetti - Andrea Fulcheri - Giovanni Succo


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