Sudden Asphyxia Caused by Retropharyngeal Hematoma after Blunt Thyrocervical Artery Injury

Iizuka, Shinichi; Morita, Seiji; Otsuka, Hiroyuki; Yamagiwa, Takeshi; Yamamoto, Rie; Aoki, Hiromichi; Fukushima, Tomokazu; Inokuchi, Sadaki

doi:10.1016/j.jemermed.2011.05.094

Cited by 21 publications

(15 citation statements)

References 19 publications

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“…RPH is generally associated with cervical spine injury [4]. The thyrocervical artery [4][5][6][7] and vertebral artery [1,8] have been reported as sources of RPH. There are also RPH cases following stellar ganglion block [9] or anterior cervical fusion [10].…”

Section: Discussionmentioning

confidence: 99%

Successful management of retropharyngeal hematoma by trans-arterial embolism without intubation

et al. 2021

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Background Retropharyngeal hematoma can cause suffocation if there is delay in securing the airway by intubation. However, there are also concerns about complications that can arise with intubation; it is still unknown which cases do not require intubation. Case presentation An 88-year-old woman slipped and was found prone and was transported to the emergency room. She was alert without any stridor. Physical examination revealed a subcutaneous hematoma in the anterior cervical region. Computed tomography revealed a retropharyngeal hematoma. Angiography and computed tomography angiography showed extravasation from the right costocervical trunk. A radiologist performed trans-arterial embolization, and she had an uneventful course without intubation or developing any complication. She became ambulatory on postoperative day 5. Conclusion Angiography and computed tomography angiography help in early recognition of extravasation in retropharyngeal hematoma, and trans-arterial embolization can help to avoid intubation and its complications.

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Section: Discussionmentioning

confidence: 99%

Successful management of retropharyngeal hematoma by trans-arterial embolism without intubation

et al. 2021

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“…Conservative management has been successfully utilized with an understanding that this may entail a period of extended observation of up to three weeks until a complete resolution of the symptoms and underlying hematoma occurs [ 8 ].The use of angiography guided embolization or surgical exploration should be considered in the setting of progression of the expanding hematoma and marked airway obstruction [ 10 , 11 ]. Potential sources of bleeding identifiable on angiogram and surgical exploration are multiple including the anterior longitudinal ligaments, inferior thyroid artery, and the thyrocervical artery [ 1 , 11 – 13 ]. Although frequently administered, the benefit of steroids and antibiotics for retropharyngeal hematoma is unclear [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Retropharyngeal hematomas are an uncommon yet potentially life threatening emergency due the proximity to the upper airway. Frequently reported in the setting of trauma with or without associated bony injury, retropharyngeal hematomas have been described following hemorrhagic transformation of underlying mass lesions and infections, as a complication of central line and nasogastric tube placement, in addition to occurring as a spontaneous unprovoked bleeding event [ 1 – 5 ]. Individuals with hemophilia and those taking anticoagulants such as warfarin appear to be at an increased risk of retropharyngeal hematomas [ 4 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Traumatic Retropharyngeal Hematoma in a Patient Taking Clopidogrel

Betten

Jaquint

2018

Case Reports in Emergency Medicine

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The development of a retropharyngeal hematoma may lead to acute airway compromise requiring emergent airway stabilization. We describe the development of a retropharyngeal hematoma in an elderly woman who sustained a fall from standing approximately 10 hours prior to symptom onset who was taking the antiplatelet agents clopidogrel and aspirin. This delayed onset of rapid airway compromise secondary to a retropharyngeal hematoma following a fall in a patient taking clopidogrel is an unusual and potentially life threatening event.

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“…As extravasation of contrast agent was observed on emergency CECT scan, emergency angiography was performed and hemorrhage from the right thyrocervical artery was diagnosed. 14 All of the above cases had been managed successfully.…”

Section: Bengal Journal Of Otolaryngology and Head Neck Surgery Vol 23 No 1 April 2015mentioning

confidence: 95%

Retropharyngeal Hematoma Secondary to Minor Blunt Trauma Neck: A Rare Case Report

Paul

Sen

Palai

et al. 2015

BJOHNS

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Introduction Traumatic retropharyngeal hematoma is rare, but can be lethal, if not identified and managed promptly. It isclinically important because of the close proximity of the retropharyngeal space to the upper airway. Case report A case of upper airway obstruction in a 75 year old man due to a large retropharyngeal hematoma following minor injury to neckis presented.Progressive dysphagia, hoarseness and dyspnoea developed over time. Emergency tracheostomy and subsequent surgical drainage was performed. Conclusion Retropharyngeal hematoma is a rare but potentially lethal problem that can be faced in an emergency department. Clinicians should be alert to the potential occurrence of this cause of acute or delayed airway collapse. Thus, an awareness of the possibility of airway obstruction secondary to massive hematoma formation after an asymptomatic interval is needed.

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Sudden Asphyxia Caused by Retropharyngeal Hematoma after Blunt Thyrocervical Artery Injury

Cited by 21 publications

References 19 publications

Successful management of retropharyngeal hematoma by trans-arterial embolism without intubation

Successful management of retropharyngeal hematoma by trans-arterial embolism without intubation

Traumatic Retropharyngeal Hematoma in a Patient Taking Clopidogrel

Retropharyngeal Hematoma Secondary to Minor Blunt Trauma Neck: A Rare Case Report

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