Spontaneous cervical hemorrhage with near-complete airway obstruction

Chin, Kenley W.; Sercarz, Joel A.; Wang, Marilene B.; Andrews, Robert G.

doi:10.1002/(sici)1097-0347(199807)20:4<350::aid-hed10>3.0.co;2-m

Cited by 47 publications

(45 citation statements)

References 27 publications

(34 reference statements)

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“…Retropharyngeal hematoma is an uncommon occurrence, but may cause rapid, life-threatening airway obstruction (1,2). This report describes a case of spontaneous retropharyngeal hematoma due to hemorrhage from a thoracic aortic dissection, and illustrates the potential serious consequence of massive blood loss.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous retropharyngeal hematoma: An unusual presentation of thoracic aortic dissection

Newton

2006

The Journal of Emergency Medicine

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Section: Introductionmentioning

confidence: 99%

Spontaneous retropharyngeal hematoma: An unusual presentation of thoracic aortic dissection

Newton

2006

The Journal of Emergency Medicine

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“…There are only a few case reports in the recent literature [2]. Retropharyngeal hematomas are, although extremely uncommon, associated with a range of conditions including cervical trauma, anticoagulation, bleeding diathesis, following internal jugular vein cannulation, arteriography and carotid sinus massage [3,4].…”

Section: Discussionmentioning

confidence: 99%

“…Bleeding into the retropharyngeal space is serious because the anatomic peculiarity of the pharyngeal muscles offers no resistance to the expanding hematoma. Compression of the arytenoids cartilages can occur, closing the vocal and obstructing the airway [4].…”

Section: Discussionmentioning

confidence: 99%

Retropharyngeal Hematoma Secondary to Vomiting in a Healthy Adult: A Case Report

Cho

2015

J Med Cases

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Nontraumatic spontaneous retropharyngeal hematoma is rarely encountered. Clinical diagnosis of retropharyngeal hematoma can be difficult and may be infrequently misdiagnosed with acute pharyngitis. A careful history taking is also an important process to diagnose this disease entity. Because of its rarity and difficulty of early diagnosis, retropharyngeal hematoma may rapidly progress to airway compromise. A 51-year-old woman suddenly developed neck pain and dyspnea after vomiting. Examination showed anterior bulging of the posterior oropharyngeal wall without ecchymosis around neck. No underlying medical conditions, medications, or trauma were found. Cervical magnetic resonance imaging revealed retropharyngeal hematoma collection from nasopharynx to laryngopharynx. We report a case of spontaneous retropharyngeal hematoma with increased intrathoracic pressure caused by vomiting.

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“…After keeping the upper airway open, two treatments are available: drainage [1,[5][6][7] and observation [2,[4][5][6][7]. In cases of rapid expansion or bacterial infection of retropharyngeal hematoma, surgical drainage may be emergently needed to relieve the trachea from compression.…”

Section: Discussionmentioning

confidence: 99%

“…Retropharyngeal hematoma may occur in any age group [1]. Its etiologic factors include anticoagulation or bleeding disorder, tumor, ruptured aneurysm, infection, and major cervical injury [2][3][4][5][6]. It is sometimes associated with internal jugular venous cannulation, arteriography, carotid sinus massage, or hyperextension injury, and also occurs spontaneously [1][2][3][4][5].…”

Section: Discussionmentioning

confidence: 99%

Acute airway obstruction secondary to retropharyngeal hematoma

Shiratori

Hara

Ando

2003

Journal of Anesthesia

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tient without a surgeon's assistance. Tracheal intubation prior to transport was desired. However, the physician made an optimistic prediction that the patient would not choke during transport because he was not stridorous at that time. He was transported to Iida Municipal Hospital by ambulance. During transport, he felt dyspneic in the supine position and was placed in the sitting position with 5 l/min of oxygen.About 1 h later the ambulance arrived and a surgeon examined the patient. Physical examination revealed the patient had dyspnea but was making an effort to breathe deeply in the sitting position. Respiratory rate was about 20-25 breaths per minute. His neck was short and thick with no palpable mass. There was no area of ecchymosis on his posterior neck. SpO 2 was 95%-96% on 5 l/min of oxygen. Approximately 30 min after the patient's arrival, the surgeon decided to carry out CT to reevaluate the size of the hematoma before operation. During the CT scan, dyspnea developed suddenly and the patient became tachypneic. The surgeon tried tracheal intubation over and over again with an inside diameter (I.D.) 8.0-mm tracheal tube, but was unsuccessful. The surgeon gave diazepam 10 mg intravenously to the patient to sedate him for easy tracheal intubation. Then the patient became cyanosed and the SpO 2 fell below 85%. The surgeon called an anesthesiologist urgently for assistance of airway management.The anesthesiologist attempted to intubate with an I.D. 7.5-mm tracheal tube, but was also unsuccessful. Then the anesthesiologist reattempted, directing the surgeon to prepare fiberoptic intubation and emergent tracheostomy. The anesthesiologist successfully intubated blindly with an I.D. 6.0-mm tracheal tube. The patient was quickly relieved from dyspnea with no resistance to breathing. CT scan revealed no further extension of retropharyngeal hematoma and showed that the tracheal tube, which was fixed at a right oral angle at a depth of 26 cm from its end, was placed about 5.5 cm proximal from tracheal bifurcation and the most

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Spontaneous cervical hemorrhage with near-complete airway obstruction

Cited by 47 publications

References 27 publications

Spontaneous retropharyngeal hematoma: An unusual presentation of thoracic aortic dissection

Spontaneous retropharyngeal hematoma: An unusual presentation of thoracic aortic dissection

Retropharyngeal Hematoma Secondary to Vomiting in a Healthy Adult: A Case Report

Acute airway obstruction secondary to retropharyngeal hematoma

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