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

Arana-Garza, Sebastian; Juarez-Parra, Marco A; Monterrubio-Rodríguez, Jeronimo; Cedillo-Alemán, Enrique; Orozco-Agüet, David; Zamudio-Vázquez, Zaire; Garza-Jasso, Tanya

doi:10.1016/j.ijscr.2015.04.020

Cited by 13 publications

(3 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When plain CT cannot show radiological signs of potential vascular injuries, which may delay patients’ diagnoses, contrast-enhanced CT is more sensitive for vascular injuries[ 16 ]. In an emergency, contrast-enhanced CT is helpful in revealing details regarding the vessels and surrounding structures, such as angiorrhexis and hematoma[ 17 , 18 ]. In a retrospective study of 67 patients with penetrating neck injuries, combining clinical signs and radiological evidence improved the accuracy of exploration of injured vessels to 97.7%[ 19 ].…”

Section: Discussionmentioning

confidence: 99%

External penetrating laryngeal trauma caused by a metal fragment: A Case Report

Qiu¹,

Zeng²,

Zuo³

et al. 2022

WJCC

View full text Add to dashboard Cite

BACKGROUND Although external penetrating laryngeal trauma is rare in the clinic, such cases often result in a high mortality rate. The early recognition of injury, protection of the airway, one-stage laryngeal reconstruction with miniplates and interdisciplinary cooperation are important in the treatment of such patients. CASE SUMMARY A 58-year-old male worker sustained a penetrating injury in the left neck. After computed tomography scanning at a local hospital, he was transferred to our hospital, where he underwent tracheotomy, neck exploration, extraction of the foreign object, debridement and repair of the thyroid cartilage using titanium miniplates. An endo laryngeal stent was inserted, which was removed 12 days later. The patient recovered well and his voice rapidly improved after surgery. CONCLUSION Penetrating laryngeal trauma is uncommon. We successfully treated a patient with early laryngeal reconstruction and management by interdisciplinary cooperation.

show abstract

Section: Discussionmentioning

confidence: 99%

External penetrating laryngeal trauma caused by a metal fragment: A Case Report

Qiu¹,

Zeng²,

Zuo³

et al. 2022

WJCC

View full text Add to dashboard Cite

show abstract

“…3 Our patient suffered from direct, blunt trauma to the neck, but other similar injuries noted were penetrating neck injuries, vehicular accidents, assaults, sports-related injuries, and fine-needle aspiration. [1][2][3][4][5][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Occurring less commonly are those arising from indirect mechanisms such as straining from heavy physical activities, Valsalva from coughing or defecating, and deceleration injuries. 1,3,4 There have also been rare instances of spontaneous thyroid bleeding, but most were associated with preexisting thyroid pathology and chronic anticoagulation.…”

Section: Discussionmentioning

confidence: 99%

Thyroid Rupture Secondary to Blunt Neck Trauma: A Case Report

Perdon-Chan¹,

Roasa²

2022

Craniomaxillofacial Research & Innovation

View full text Add to dashboard Cite

Aim To discuss the clinical presentation of thyroid rupture following blunt neck trauma and highlight key management principles for the case. Methods A 45-year-old female motorcycle passenger with a pre-existing right thyroid nodule hit her right anterior neck against a bottle during sudden stop and developed painful right neck swelling, odynophagia, and hoarseness. She was seen at the emergency room 5 hours post-injury, awake, cooperative, and ambulatory, without stridor or dyspnea at room air. On examination, she had ecchymoses behind her right tonsillar pillars; her neck was grossly swollen and was tender on palpation without subcutaneous emphysema. Laryngoscopy showed good left vocal cord mobility while the right vocal cord had a visible hemorrhage and limited abduction due to the mass effect of the hematoma seen at the right aryepiglottic area extending toward the right piriform fossa and the right parapharyngeal area. Intact bilateral vocal cord adduction was noted upon phonation. Contrast-enhanced computed tomography revealed hematoma formation in the right thyroid lobe area with extension to the right side of the oropharyngeal region, anterior cervical, parapharyngeal, and retropharyngeal space, confirming the aerodigestive tract narrowing and leftward deviation previously noted. Baseline thyroid function tests were normal. Under general anesthesia, the patient underwent neck exploration where the ruptured right thyroid lobe was resected, and the hematoma was evacuated. Results Postoperatively noted significant improvement in neck swelling, odynophagia, and hoarseness. Transient subclinical hyperthyroidism remained asymptomatic and resolved upon outpatient follow-up. A year after the surgery, the patient had a well-healed cervical scar, complete hematoma resolution, and regained her pre-morbid phonation. Conclusion Thyroid gland rupture should be among the considerations for patients presenting with tender neck swelling, progressive hoarseness, and/or dyspnea following neck trauma. Prompt airway assessment and close monitoring for potential compromise are essential to avoid fatal sequelae of external airway compression. Management varies from close observation to surgical neck exploration and should be personalized depending on the severity of thyroid injury and symptomatology.

show abstract

“…If management of a surgical airway is required, it may obviate cricothyrotomy due to the presence of an anterior hematoma. Intubation may not be necessary in all cases, but close observation is required, as life-threatening airway compression secondary to progressive hematoma or soft tissue edema may occur later [5] , [6] .…”

Section: Discussionmentioning

confidence: 99%