Emergency Management of a Spontaneous Rupture of the Superior Thyroid Artery via Pharyngeal Foley Balloon Tamponade: A Case Report.

Spontaneous rupture of the superior thyroid artery (STA) is a very rare cause of oropharyngeal hemorrhage and airway emergency. The majority of cases occur secondary to aneurysm, trauma, post-surgical complications, or iatrogenic causes. In this report, we present the case of a 27-year-old, previously healthy male who arrived with sudden-onset neck swelling, stridor, and massive oropharyngeal bleeding. On arrival, the airway was immediately secured through suction-assisted endotracheal intubation. Computed tomography angiography (CTA) revealed active extravasation from the STA, without evidence of aneurysm. Hemostasis was achieved by inserting a pharyngeal Foley balloon tamponade as a minimally invasive intervention, avoiding the need for surgical ligation or endovascular embolization. The patient recovered without complications and remained symptom-free at six-month follow-up. This case highlights the rarity of spontaneous STA rupture and emphasizes the potential effectiveness of pharyngeal Foley balloon tamponade as a minimally invasive technique, which can serve both as an immediate first-line intervention and as definitive management, providing safe and sustained long-term outcomes. This underscores the importance of multidisciplinary collaboration in the diagnosis and management of such challenging cases.