Persistent dyspnea following thyroid hematoma after neck blunt trauma

Donatini, Gianluca

doi:10.1007/s13304-011-0076-5

Cited by 8 publications

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3 Our patient suffered from direct, blunt trauma to the neck, but other similar injuries noted were penetrating neck injuries, vehicular accidents, assaults, sports-related injuries, and fine-needle aspiration. [1][2][3][4][5][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Occurring less commonly are those arising from indirect mechanisms such as straining from heavy physical activities, Valsalva from coughing or defecating, and deceleration injuries. 1,3,4 There have also been rare instances of spontaneous thyroid bleeding, but most were associated with preexisting thyroid pathology and chronic anticoagulation.…”

Section: Discussionmentioning

confidence: 99%

“…5 Aside from clinical presentation, another factor to consider is whether the patient has concomitant thyroid pathology (adenoma, cyst, multinodular goiter, and carcinoma) as resecting the diseased thyroid would remove the risk of continued, delayed bleeding from the fragile goitrous tissue and future operation or reoperation from nonresolution or persistent compressive symptoms. 14,17,18…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Thyroid Rupture Secondary to Blunt Neck Trauma: A Case Report

Perdon-Chan¹,

Roasa²

2022

Craniomaxillofacial Research & Innovation

View full text Add to dashboard Cite

Aim To discuss the clinical presentation of thyroid rupture following blunt neck trauma and highlight key management principles for the case. Methods A 45-year-old female motorcycle passenger with a pre-existing right thyroid nodule hit her right anterior neck against a bottle during sudden stop and developed painful right neck swelling, odynophagia, and hoarseness. She was seen at the emergency room 5 hours post-injury, awake, cooperative, and ambulatory, without stridor or dyspnea at room air. On examination, she had ecchymoses behind her right tonsillar pillars; her neck was grossly swollen and was tender on palpation without subcutaneous emphysema. Laryngoscopy showed good left vocal cord mobility while the right vocal cord had a visible hemorrhage and limited abduction due to the mass effect of the hematoma seen at the right aryepiglottic area extending toward the right piriform fossa and the right parapharyngeal area. Intact bilateral vocal cord adduction was noted upon phonation. Contrast-enhanced computed tomography revealed hematoma formation in the right thyroid lobe area with extension to the right side of the oropharyngeal region, anterior cervical, parapharyngeal, and retropharyngeal space, confirming the aerodigestive tract narrowing and leftward deviation previously noted. Baseline thyroid function tests were normal. Under general anesthesia, the patient underwent neck exploration where the ruptured right thyroid lobe was resected, and the hematoma was evacuated. Results Postoperatively noted significant improvement in neck swelling, odynophagia, and hoarseness. Transient subclinical hyperthyroidism remained asymptomatic and resolved upon outpatient follow-up. A year after the surgery, the patient had a well-healed cervical scar, complete hematoma resolution, and regained her pre-morbid phonation. Conclusion Thyroid gland rupture should be among the considerations for patients presenting with tender neck swelling, progressive hoarseness, and/or dyspnea following neck trauma. Prompt airway assessment and close monitoring for potential compromise are essential to avoid fatal sequelae of external airway compression. Management varies from close observation to surgical neck exploration and should be personalized depending on the severity of thyroid injury and symptomatology.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Thyroid Rupture Secondary to Blunt Neck Trauma: A Case Report

Perdon-Chan¹,

Roasa²

2022

Craniomaxillofacial Research & Innovation

View full text Add to dashboard Cite

show abstract

“…Conservative or surgical treatment should be determined on the basis of CT findings and vital signs. Securing the airway when necessary should be the priority [ 15 ]. The thyroid gland has a rich blood supply that can easily result in an expanding hematoma capable of causing airway compromise.…”

Section: Discussionmentioning

confidence: 99%

Thyroid gland rupture caused by blunt trauma to the neck

2016

View full text Add to dashboard Cite

BackgroundThyroid rupture following blunt trauma is extremely rare, and neck pain without swelling may be the only presenting symptom. However, hemorrhage and hematoma subsequently causes severe tracheal compression and respiratory distress.Case presentationA 71-year-old Japanese woman visited our emergency room with a complaint of increasing right-sided neck pain at the thyroid cartilage level after she tripped and accidentally hit her neck against a pole 3 h back. On admission, her vital signs were stable. There was no swelling or subcutaneous emphysema. Laryngeal endoscopy revealed mild laryngeal edema, although there was no impairment in vocal fold mobility on either side. Contrast-enhanced computed tomography (CT) revealed rupture of the right lobe of the thyroid gland accompanied by a large hematoma extending from the neck to the mediastinum. Under general anesthesia, the right lobe was resected and the hematoma was evacuated.ConclusionOnly a few isolated cases of thyroid rupture caused by blunt neck trauma have been reported in patients with normal thyroid glands and neck pain without swelling may be the only presenting symptom. When suspected, CT should be performed to confirm the diagnosis determine the optimal treatment.

show abstract

“…Although more than half of the cases were handled with surgical exploration, a more conservatory approach with only observation (mean 72 h) has proven to be a feasible option [11,15] . Close monitoring after discharge either with laboratory tests or sonography is advised; a case of persistent dyspnea due to a non-resolved hematoma, initially treated with observation, has been described 5 months after the original eve [16] .…”

Section: Discussionmentioning

confidence: 99%

Thyroid gland rupture after blunt neck trauma: A case report and review of the literature

Arana-Garza¹,

Juarez-Parra²,

Monterrubio-Rodríguez³

et al. 2015

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

HighlightsThe proximity to the skin’s surface make several vital structures vulnerable to injury after blunt neck trauma.Isolated injury to the thyroid gland is rare and most cases have a predisposing disease such as goiter.CT-scan is helpful in evaluating the neck structures and evidencing injury to the thyroid.Surgical exploration remains the most common treatment strategy, all cases should be individualized.

show abstract

Persistent dyspnea following thyroid hematoma after neck blunt trauma

Cited by 8 publications

References 12 publications

Thyroid Rupture Secondary to Blunt Neck Trauma: A Case Report

Thyroid Rupture Secondary to Blunt Neck Trauma: A Case Report

Thyroid gland rupture caused by blunt trauma to the neck

Thyroid gland rupture after blunt neck trauma: A case report and review of the literature

Contact Info

Product

Resources

About