Traumatic common carotid-jugular fistula: report of 2 cases.

Traumatic common carotid artery-to-internal jugular vein fistula is a rare entity that is not usually detected during the acute injury phase. We present 2 cases of traumatic carotid-jugular fistula. Both involved the right side of the neck, and both were due to injury from a firearm. The patients exhibited signs of high cardiac output. In Patient 1, the diagnosis was made by clinical examination and radiography. After diagnosis, the patient's parents requested his discharge from the hospital because of an inability to pay for treatment. The patient did not return. Patient 2 had a brachial plexus injury in addition to a carotid-jugular fistula. Diagnosis of the fistula was confirmed by color-flow echo Doppler scanning. Treatment consisted of division of the fistula and direct suture repair. The surgery required cross-clamping of the common carotid artery for 25 minutes; nonetheless, the patient recovered without cerebral ischemia. Carotid-jugular fistula should always be treated early to avoid the complications associated with the injury.