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JBJS Case Connect 2022 Apr 4;12(2). Epub 2022 May 4.

Washington State University, Elson S. Floyd College of Medicine, Spokane, Washington.

Case: A 71-year-old woman with a 2-year history of spondylosis and radiculopathy presented with progressively worsening cervical spine pain and neurological dysfunction for 2 years. The patient developed posterior reversible encephalopathy syndrome (PRES) after postoperative hematoma in the retroesophageal and retropharyngeal areas. This occurred status post anterior cervical diskectomy and fusion (ACDF) of C4-C6. Read More

Cureus 2022 Jun 19;14(6):e26087. Epub 2022 Jun 19.

Orthopaedics, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, JPN.

Airway narrowing due to trauma-induced retropharyngeal hematoma is rare. However, it is dangerous to overlook this lesion because it can lead to airway obstruction and even death. In this article, we report a case of a patient who developed pharyngeal pain and dysphagia two days after bruising on the forehead due to a fall and required intubation management. Read More

Forensic Sci Med Pathol 2022 06 30;18(2):219-222. Epub 2022 Mar 30.

The University of Adelaide, Frome Rd, Adelaide, 5005, Australia.

Extensive retropharyngeal haemorrhage is a rare event, which is occasionally encountered in clinical practice, but very seldom at autopsy. A 43-year-old woman who presented with difficulty breathing after a week's history of sore throat and coughing is reported. She collapsed at a medical centre and was not able to be resuscitated. Read More

Respir Med Case Rep 2022 18;36:101613. Epub 2022 Feb 18.

Department of Medicine, Pulmonary and Critical Care, Oklahoma State University College of Osteopathic Medicine, Tahlequah, OK, USA.

Acute upper airway obstruction secondary to supraglottic hematoma is a rare but life-threatening complication of oral anticoagulants, particularly with warfarin. Symptoms include sore throat, dysphagia, odynophagia, dysphonia, neck swelling, and dyspnea. We are reporting a case of an elderly male on warfarin therapy who developed acute upper airway obstruction due to spontaneous supraglottic hemorrhage. Read More

Respir Med Case Rep 2022 19;36:101612. Epub 2022 Feb 19.

Department of Medicine, Pulmonary and Critical Care, Oklahoma State University College of Osteopathic Medicine, Tahlequah, OK, USA.

Acute upper airway obstruction secondary to supraglottic hematoma is a rare but life-threatening complication of oral anticoagulants, particularly with warfarin. Symptoms include sore throat, dysphagia, odynophagia, dysphonia, neck swelling, and dyspnea. We are reporting a case of an elderly male on warfarin therapy who developed acute upper airway obstruction due to spontaneous supraglottic hemorrhage. Read More

Can J Anaesth 2022 Jun 14;69(6):784-785. Epub 2022 Feb 14.

Department of Anesthesia, Vancouver Acute (Vancouver General Hospital and UBC Hospital), The University of British Columbia, Vancouver, BC, Canada.

Int J Spine Surg 2021 Dec;15(6):1167-1173

Department of Spine Surgery, Zentralklinik Bad Berka, Germany.

Background: The clinical outcome of anterior cervical decompression and fusion (ACDF) correlates with fusion rates. There is a debate about how patients with symptomatic pseudarthrosis should be managed. In this study, a treatment plan is developed based on the surgical results of 95 patients and the recent literature. Read More

Int J Spine Surg 2021 Dec;15(6):1155-1161

Department of Spine Surgery, Zentralklinik Bad Berka, Germany.

Background: The clinical outcome of anterior cervical decompression and fusion (ACDF) correlates with fusion rates. There is a debate about how patients with symptomatic pseudarthrosis should be managed. In this study, a treatment plan is developed based on the surgical results of 95 patients and the recent literature. Read More

J Forensic Leg Med 2022 Jan 15;85:102274. Epub 2021 Nov 15.

Department of Forensic Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Purpose: Traumatic retropharyngeal haematoma, a condition of low incidence, often occurs secondary to cervical injuries. Owing to the adjacent anatomical location and its insidious formation, retropharyngeal haematoma is prone to cause airway obstruction, which can occasionally be fatal. Though well known in clinical practice, retropharyngeal haematomas are rarely encountered in forensic practice and are not sufficiently explored from a forensic perspective. Read More

Emerg Med Int 2021 7;2021:5158403. Epub 2021 Oct 7.

Emergency Department, Chi-Mei Medical Center, Tainan, Taiwan.

Background: In patients with blunt trauma, particularly geriatric patients and those with minor trauma, an insidious retropharyngeal hematoma (RH) may deteriorate and have lethal consequences. We review the relevant literature to elucidate the clinical characteristics, treatment, complications, and outcomes of blunt traumatic RH with respiratory symptoms. . Read More

J Laryngol Otol 2021 Nov 31;135(11):1031-1034. Epub 2021 Aug 31.

Department of ENT, Southampton, England, UK.

Background: Retropharyngeal haematomas are most commonly associated with trauma and anti-coagulant use. This paper describes the first reported case of a spontaneous retropharyngeal haematoma suspected to be due to indomethacin use.

Case Report: It is proposed that the combination of indomethacin affecting platelet aggregation, alongside the patient coughing, may have led to this retropharyngeal haematoma. Read More

Clin Pract Cases Emerg Med 2021 May;5(2):255-257

Stony Brook University, Department of Emergency Medicine, Stony Brook, New York.

Case Presentation: An elderly man presented to the emergency department after a fall from a 15-foot height. Initial examination revealed signs of head and neck trauma without airway compromise. Computed tomography imaging identified cervical fractures at the first and second level with a retropharyngeal hematoma. Read More

Eur J Med Res 2021 Jul 20;26(1):77. Epub 2021 Jul 20.

Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Background: Among the several complications associated with anterior cervical discectomy and fusion (ACDF), airway compromise is considered one of the serious life-threatening conditions and usually requires emergent treatment, including airway establishment and hematoma evacuation surgery. Postoperative retropharyngeal hematoma commonly occurred during the on immediate phase with airway compromise, but have a rarity on late onset of this complication. Enlightened by this existing fact, we report the first case of delayed onset postoperative retropharyngeal hematoma after anterior cervical surgery with a sequela of tracheal stricture. Read More

BJR Case Rep 2021 May 21;7(3):20200190. Epub 2021 Apr 21.

Consultant Interventional Head & Neck Radiologist, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK.

Delayed life-threatening airway obstruction due to venous injury following blunt, non-penetrative trauma to the neck. A rare case of rapid force, blunt trauma by closing train carriage doors, leading to injury to the left internal jugular vein, subsequent retropharyngeal haematoma and airway obstruction. There was a significant delay of a few hours between injury and acute deterioration. Read More

BMJ Case Rep 2021 May 13;14(5). Epub 2021 May 13.

Ear, nose and throat, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.

A 79-year-old man presented to the emergency department following a 1-week history of dyspnoea, dysphonia, dysphagia and a nonproductive cough. Previous medical history included atrial fibrillation, for which he was taking rivaroxaban, hypertension and obstructive sleep apnoea. On assessment, there was a mild stridor, swelling of the anterior aspect of the neck and submandibular bruising. Read More

BMC Surg 2021 Apr 27;21(1):220. Epub 2021 Apr 27.

Department of Radiology, Chungbuk National University Hospital, 776, 1sunhwan-ro, Seowon-g, Cheongju-si, Chungcheongbuk-do, Republic of Korea.

Background: Fine needle aspiration (FNA) of the thyroid gland is an effective and safe method for evaluating thyroid nodules; catastrophic complications following FNA of thyroid are rare. Massive hematomas with active bleeding leading to airway compromise are extremely rare complications of FNA, with only a few reported cases in literature.

Case Presentation: An 80 year-old man presented to the emergency room with severe respiratory distress, four hours after undergoing thyroid FNA for the evaluation of a thyroid nodule. Read More

J Belg Soc Radiol 2021 Mar 16;105(1):15. Epub 2021 Mar 16.

Clinique Saint-Pierre Ottignies, BE.

Retropharyngeal hematoma appearing under rivaroxaban is uncommon but should be suspected in cases of dysphagia, dysphonia or breathing difficulties. Read More

Trauma Case Rep 2021 Apr 20;32:100442. Epub 2021 Feb 20.

Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, United States of America.

We described the case of 75 years old male patient with an airway obstruction due to retropharyngeal hematoma that developed after a minor blunt trauma to the face. The patient was not taking any anticoagulants or antiplatelet agents and did not have any coagulopathy. This case report indicates that emergency physicians must be aware of the risk of delayed airway obstruction in elderly patients regardless of whether the patient is using anticoagulants or antiplatelet agents. Read More

Am J Otolaryngol 2021 Jul-Aug;42(4):102962. Epub 2021 Feb 16.

Department of Otolaryngology-H&N Surgery, Louisiana State University Health-Shreveport, 1501 King's Highway, Shreveport, LA 71130, USA.

Pseudoaneurysms are very rare with an incidence of less than 0.1% in the pediatric population. Approximately 30 cases of carotid artery aneurysms in children have been published in the literature, usually affecting children over one year of age. Read More

Acute Med Surg 2021 Jan-Dec;8(1):e632. Epub 2021 Feb 6.

Department of Anesthesiology and Critical Care Saitama Medical Center Jichi Saitama Japan.

Am J Emerg Med 2021 08 2;46:799.e3-799.e4. Epub 2021 Feb 2.

Department of Emergency Medicine, Japanese Red Cross Ishinomaki Hospital, Miyagi, Japan.

Retropharyngeal hematoma is a potentially life-threatening condition because it can easily lead to airway obstruction. Most of the previously reported cases of retropharyngeal hematoma are caused by predisposing factors such as head and neck trauma, the use of anticoagulants, or the presence of underlying bleeding diathesis. Herein, we report a case of retropharyngeal hematoma in a patient with chronic alcoholism, where we could not confirm any predisposing factors at the time of examination. Read More

Int J Emerg Med 2021 Jan 7;14(1). Epub 2021 Jan 7.

Emergency and Critical Care Medical Center, Teine Keijinkai Hospital, 1-jo 12-chome 1-40, Maeda, Teine-ku, Sapporo, 006-8555, Japan.

Background: Retropharyngeal hematoma can cause suffocation if there is delay in securing the airway by intubation. However, there are also concerns about complications that can arise with intubation; it is still unknown which cases do not require intubation.

Case Presentation: An 88-year-old woman slipped and was found prone and was transported to the emergency room. Read More

Clin Pract Cases Emerg Med 2020 Nov;4(4):634-635

University of Ottawa, Department of Emergency Medicine, Ottawa, Ontario, Canada.

Case Presentation: A 63-year-old female presented to the emergency department complaining of cough, neck swelling, dysphagia, and dysphonia for two days, with a past medical history of atrial fibrillation managed with warfarin. Investigations revealed a supratherapeutic international normalised ratio (greater than 10). Imaging and endoscopic examination showed an extensive retropharyngeal hematoma with significant mass effect on the airway. Read More

Int J Surg Case Rep 2020 4;77:321-324. Epub 2020 Nov 4.

Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.

Introduction: Blunt neck trauma patients can suffer from an airway emergency and are necessary to careful observation.

Presentation Of Case: A 79-year-old man under anticoagulation therapy presented to our hospital three hours after a fall. Shortly after arrival, he developed dyspnea. Read More

Surg Neurol Int 2020 21;11:356. Epub 2020 Oct 21.

Clinical Professor of Neurological Surgery, School of Medicine, State University of NY at Stony Brook, New York, United States.

Background: We reviewed the frequency, recognition, and management of postoperative hematomas (HT) (i.e. retropharyngeal [RFH], wound [WH], and/or spinal epidural hematomas [SEH]) following anterior cervical discectomy/fusion (ACDF), anterior corpectomy fusion (ACF), and/or anterior cervical spine surgery (ACSS). Read More

Korean J Neurotrauma 2020 Oct 26;16(2):343-347. Epub 2020 Oct 26.

Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Busan, Korea.

Traumatic retropharyngeal hematoma is a potentially life-threatening complication of cervical spine injury due to possible airway obstruction. Treatment by securing airway and subsequent conservative care is often adequate. However, a rapidly expanding large hematoma requires surgical evacuation. Read More

Med Klin Intensivmed Notfmed 2021 10 15;116(7):624-626. Epub 2020 Oct 15.

Interdisziplinäre Intensivstation, Spital Bülach, 8180, Bülach, Schweiz.

Global Spine J 2021 Jun 13;11(5):704-708. Epub 2020 May 13.

Swedish Medical Center, Seattle, Washington, DC, USA.

Study Design: Cadaver study.

Objective: The retropharyngeal space's (RPS's) clinical relevance is apparent in anterior cervical spine surgery with respect to postoperative hematoma, which can cause life-threatening airway obstruction. This cadaver study aims to establish guidance toward a better understanding of the tolerance of the RPS to accommodate fluid accumulation. Read More

No Shinkei Geka 2020 Aug;48(8):707-710

Department of Neurosurgery, Makita General Hospital.

Retropharyngeal hematomas are uncommon, but they may rarely cause occlusion of the upper airway and threaten life. Retropharyngeal hematomas often occur due to head or neck injury;they rarely occur due to iatrogenic causes such as insertion of a gastric tube or anticoagulant therapy. It has been found that patients receiving anticoagulant therapy are more likely to experience potentially severe retropharyngeal hematomas. Read More

Medicine (Baltimore) 2020 Jul;99(31):e21528

Department of Thoracic & Cardiovascular Surgery, Korea University Anam Hospital, Seoul, Korea.

Rationale: Massive retropharyngeal hematoma secondary to a minor blunt trauma is rare and easy to be missed in emergency settings due to the absence of visible tissue injury, especially in young patients. However, missing this pathology is dangerous and can result in airway obstruction and even death. Therefore, an effective diagnostic strategy must be developed and thoroughly performed to minimize missed retropharyngeal hematoma. Read More