• Head & neck · Jul 1998

    Case Reports

    Spontaneous cervical hemorrhage with near-complete airway obstruction.

    • K W Chin, J A Sercarz, M B Wang, and R Andrews.
    • Division of Head and Neck Surgery, University of California, Los Angeles School of Medicine, 90095, USA.
    • Head Neck. 1998 Jul 1;20(4):350-3.

    BackgroundRetropharyngeal hematoma is a rare entity which may progress rapidly to airway obstruction. Previously documented causes have included coagulopathic states, trauma, infection, parathyroid adenoma rupture, and foreign-object ingestion. Four cases of spontaneous retropharyngeal hematomas without any known predisposing risk factors have been previously reported. Two of these cases had fatal outcomes.MethodsA case report is presented and the literature reviewed.ResultsSpontaneous cervical hematoma with parapharyngeal and retropharyngeal involvement which caused near-complete respiratory obstruction occurred in an otherwise healthy young man following straining. Initial management involved fiberoptic nasotracheal intubation. Subsequent right neck exploration revealed hemorrhage from a branch of the external carotid artery, which was ligated. An arteriogram revealed minimal flow through the right external carotid artery and its branches. The patient was extubated and discharged uneventfully on the fourth postoperative day.ConclusionThe possible etiology for this case is discussed, and a review of the literature and the role of surgery in the management of this entity is outlined.

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