Clinical communicationSpontaneous retropharyngeal hematoma: An unusual presentation of thoracic aortic dissection
Introduction
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. This case also highlights an unusual presentation of thoracic aortic dissection. The institutional review board waived review of this case.
Section snippets
Clinical Data
A 78-year-old woman presented to the Emergency Department (ED) with a 2-day history of swelling and ecchymosis of the neck. There had been no head or neck trauma. She had noticed hoarseness of her voice for 2 weeks but reported no problems with swallowing or breathing. Her previous medical history included hypothyroidism, treated with thyroxine, and asthma, controlled by inhaled beclomethasone and oral theophylline. She had no known bleeding disorders and there had been no recent use of oral
Discussion
The retropharyngeal space is a potential space with complex anatomy. It extends from the base of the skull to the posterior mediastinum and therefore provides a communication between the neck and chest. It also connects with other parapharyngeal spaces, hence, bleeding into this space can be seen subcutaneously on the anterior neck.
Retropharyngeal hemorrhage is an uncommon occurrence but can have serious consequences. If the hematoma is contained locally it can cause airway obstruction due to
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A Woman With Neck Swelling and Cardiac Arrest
2021, ChestCitation Excerpt :The patient died a day later. Retropharyngeal hematoma (RPH) due to a nontraumatic TAA rupture is a rare clinical entity that can be life-threatening.2,3 For this patient, the mode of arrest may be hemorrhagic shock, which was supported by the POCUS signs of hypovolemia that included small left ventricular cavity and collapsible inferior vena cava, or because of respiratory arrest, which could explain the reason that ROSC was achieved soon after successful intubation.
A 92-year-old man with retropharyngeal hematoma caused by an injury of the anterior longitudinal ligament
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2012, Hematomas: Types, Treatments and Health Risks