Management of Thyroid Gland Hemorrhage After Blunt Trauma: A Case Report and Review of the Literature

Abstract

Although blunt thyroid injury is an uncommon condition, failure to consider the diagnosis or failure to anticipate complications of thyroid hemorrhage may result in progressive bleeding and airway compromise. Decision making is based on the patient's vital signs and, if possible, the findings on a contrastenhanced CT scan of the neck.

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

“…Soft tissue injuries are relatively common after blunt neck trauma [5,6] . Direct impact to the anterior neck has been associated with vascular, bony, muscular, laryngeal, tracheal and esophageal injury [2,5] . Isolated thyroid gland injury is extremely rare and is present in about 1–2% of the cases [7] .…”

“…Early reports occurred in goitrous glands [9] which in addition to the rich vascular supply of the thyroid [2] , translates to increased gland size and vascularity or the absence of a true capsule therefore elevating the risk for hemorrhage [10,11] . Nevertheless most of recently published cases occurred in otherwise healthy individuals.…”

“…Ultrasonography allows rapid identification of hematoma, parenchymal disruption, collections and the amenability for surgical or percutaneous drainage [1,6] . The contrast enhanced CT-scan is helpful in evaluating the surrounding structures [6] , such as the presence of pre-existing conditions and any injury to vascular structures or the spine [2] . Major blood vessel rupture can be ruled out by arterial angiography [6,12] .…”

“…Blunt neck trauma is uncommon [1] . When in neutral position, the neck is protected by the head, the shoulders and the chest; hyperextension, hyper flexion, deceleration, rotation and direct blow may contribute to dull trauma to the neck [2,3] . This is why most blunt neck traumas occur during motor vehicle collisions, direct blows, sport activities or strangulation.…”