Spontaneous Retropharyngeal Haematoma in a One-Year-Old Child: A Case Report

Abstract

Spontaneous retropharyngeal haematoma is an unusual condition and difficult to diagnosis early especially in infants. It has multiple aetiological factors and can present to a number of specialists including the otolaryngologist. We describe an unusual case of a spontaneous huge retropharyngeal haematoma in 1-year-old male child which demonstrates the dramatic presentation and emphasizes the need for immediate surgical approach.

Spontaneous Retropharyngeal Haematoma: Case Report and Literature Overview

“…1 Mundra et al reported a case of spontaneous retropharyngeal hematoma where transoral surgical drainage was necessary for the management of the case. 8 This shows that the condition has to be managed according to the severity of the symptoms. If there is no airway compromise, then medical management can be attempted.…”

Spontaneous Retropharyngeal Haematoma Causing Upper Airway Obstruction in a Child: Case Report

“…This is because the bony cervicothoracic spine located posteriorly cannot bulge. As the anterior bulge increases, clinical manifestations such as neck pain, 2,3 limited neck movement, 3,4 pain on swallowing, 2,[4][5][6] stridor with respiratory distress [4][5][6][7][8][9][10] or, in extreme circumstances of bleeding, Capp's triad 5,11,12 may ensue.…”

“…These include retropharyngeal cellulitis and abscesses, 13,14 retropharyngeal oedema seen in multisystem inflammatory syndrome in children (MIS-C) 15 and Kawasaki disease, 16 thoracic duct cysts 17 or retropharyngeal haematomas. 6,8 The cases of retropharyngeal haematomas are often associated with foreign body ingestion or anticoagulation but spontaneous retropharyngeal haematomas are relatively rare. 6,8 These differential diagnoses are distinguished by radiological investigations like radiographs, CT scans and MRIs, which also aid in monitoring of disease progress.…”

“…6,8 The cases of retropharyngeal haematomas are often associated with foreign body ingestion or anticoagulation but spontaneous retropharyngeal haematomas are relatively rare. 6,8 These differential diagnoses are distinguished by radiological investigations like radiographs, CT scans and MRIs, which also aid in monitoring of disease progress. 6,10,13 Additional inflammatory markers may be required to explore infectious conditions.…”

“…The management plan to either treat conservatively, 15 medically, 13 or surgically 6,8 greatly depends on the suspected diagnosis and the symptom severity of the patient. In cases with airway compromise, it is critical to secure the airway either by intubation or tracheostomy.…”