Thyroid Gland Rupture After Blunt Cervical Trauma

Stunell, Helen; O’Brien, Julie; Benfayed, W; Torreggiani, William C.

doi:10.7863/jum.2007.26.7.992

Cited by 9 publications

(3 citation statements)

References 1 publication

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“…Common causes of thyroid injury include traffic accidents, particularly with motorcycles or bicycles, and falls or slips. Although extremely rare, spontaneous thyroid hemorrhage following the muscular effort of heavy lifting has also been reported [ 2 – 4 , 8 – 14 ]. Although rare, thyroid injury secondary to blunt neck trauma is clinically significant because hematomas can present inconspicuously and cause respiratory distress and serious complications, particularly if they are large and extending to the mediastinum.…”

Section: Discussionmentioning

confidence: 99%

“…To confirm the diagnosis of thyroid rupture, ultrasound (US) and computed tomography are essential [ 3 , 11 ]. CT reportedly exhibits high sensitivity in diagnosing tracheal ruptures in patients with blunt neck trauma and is the initial diagnostic modality of choice in stable patients [ 3 , 4 ] because it also permits the evaluation of other structures in the anterior cervix. Doppler-mode US can be useful for assessing thyroid lacerations and hematomas and is particularly useful in the emergency room prior to emergency CT.…”

Section: Discussionmentioning

confidence: 99%

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Thyroid gland rupture caused by blunt trauma to the neck

2016

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Thyroid gland rupture caused by blunt trauma to the neck

2016

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“…[ 1 , 2 ] Common causes of thyroid injury include motor vehicle accidents and falls, although spontaneous thyroid hemorrhages have been reported following muscular effort from heavy lifting. [ 3 - 5 ] Larynx, trachea, pharynx, esophagus, major blood vessels, and the spine can be compromised. [ 6 ] Isolated trauma to the thyroid gland in this context is very uncommon.…”

Section: Introductionmentioning

confidence: 99%

Thyroid gland injury after blunt neck trauma: a case report

Alayaaf

Kim

2023

Ulus Travma Acil Cerrahi Derg

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Soft-tissue injuries are relatively common after blunt neck trauma. Due to neck content, several vital structures can be compromised. Isolated trauma to the thyroid is highly uncommon, and few cases are reported in the literature. A 61-year-old otherwise healthy woman sustained blunt trauma to the left frontal half of the neck caused by seatbelt injury in a motor vehicle accident. She presented with a painful anterior neck swelling associated with dyspnea. Computed tomography showed the left thyroid lobe lacerations with features suggestive of thyroid gland active bleeding. She underwent surgical exploration with left thyroidectomy and recovered uneventfully. Isolated thyroid gland injury is infrequent and is present in about 1–2% of the cases, and in most reported cases, there is an underlining pathology within the gland. Patients can be present with neck swelling, pain, respiratory distress, and dysphagia. Patients who sustained blunt neck trauma should be assessed and stabilized according to the ATLS® principles. Injury to vital structures should be ruled out first. Although these cases are rare, physicians should consider the possibility of thyroid injury after blunt neck trauma or neck swelling is noted.

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鈍的甲状腺外傷の保存的加療中に甲状腺クリーゼを呈した1例(A case of thyroid storm after blunt thyroid injury)

智哉

雅浩

恒太郎

et al. 2019

Nihon Kyukyu Igakukai Zasshi: Japanese Journal of Japanese Asso

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要旨　鈍的甲状腺損傷は比較的稀な病態であり，その治療戦略は確立されていない。今回，我々は鈍的甲状腺損傷に対して保存的治療を選択したところ，経過中に甲状腺クリーゼを発症した症例を経験したので報告する。症例は24歳の男性。甲状腺疾患を指摘されたことはなく特記すべき既往歴なし。自動二輪車ハンドル外傷による頸部血腫のため救急搬送された。CTで甲状腺左葉損傷と血腫による軽度気管偏位を認めた。気道狭窄症状はなかったが反回神経麻痺による嗄声を認め，気管挿管による気道確保を行った。来院後血腫の増大は認めなかったため，手術介入は行わず保存的に経過観察の方針とした。第3病日に抜管したところ気道には問題なかったが，頻脈，高体温を呈すとともに不穏興奮状態に陥った。血液検査でfree triiodothyronine（FT3），free thyroxine（FT4）上昇およびthyroid stimulating hormone（TSH）低下があり甲状腺クリーゼと判断した。ステロイド，β遮断薬を投与し体温管理等の集中治療管理を行い，経過は良好であり第12病日に自宅退院した。頸部外傷では気道狭窄が問題となる血腫，血管損傷の程度により治療方針が決定されることが多いが，甲状腺外傷ではホルモン逸脱による甲状腺クリーゼ発症も念頭に置いて治療方針を決定する必要がある。

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Thyroid Gland Rupture After Blunt Cervical Trauma

Cited by 9 publications

References 1 publication

Thyroid gland rupture caused by blunt trauma to the neck

Thyroid gland rupture caused by blunt trauma to the neck

Thyroid gland injury after blunt neck trauma: a case report

鈍的甲状腺外傷の保存的加療中に甲状腺クリーゼを呈した1例(A case of thyroid storm after blunt thyroid injury)

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