Abstract
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. Data Resources. We reviewed 57 case reports and added one case from our hospital for data analysis. A total of 68 cases were included in this review. Results The ages of patients ranged from 13 to 94 years, and geriatric patients (age >66 years) constituted 61.2% of the reviewed patients. Falls (54.4%) and traffic accidents (35.3%) were the major trauma mechanisms. Most patients' symptoms developed within 24 hours of blunt trauma (95.2%), and 73.5% of patients with RH had at least one associated injury. Many patients underwent conservative treatment for RH (63.2%). Surgical treatment (23.5%) and transarterial embolization (8.8%) were used to control retropharyngeal hemorrhage. Twelve patients died; RH and cervical spinal injury were the direct causes of death in 5 patients, whereas the other 7 patients died because of cardiac, pulmonary, or gastrointestinal causes or withdrawal of life support. Conclusions Geriatric patients constituted the largest proportion of patients with RH, and minor trauma was adequate to result in RH in elderly people. The cornerstone of RH management is airway management. Surgery and transarterial embolization are commonly used to control active bleeding in patients with RH. The long-term outcome depends on patients' associated injuries and in-hospital complications.
Highlights
Retropharyngeal hematoma (RH) is a potentially lifethreatening disease because the expanding hematoma may progress to completely obstruct the airway
In accordance with the distributions of most reports of trauma, male predominance was discovered in patients with blunt traumatic retropharyngeal hematoma (RH)
We discovered that 68% of patients with RH had an associated cervical spinal injury, including cervical spinal fracture or dislocation and ligament injury, supporting this hypothesis
Summary
Retropharyngeal hematoma (RH) is a potentially lifethreatening disease because the expanding hematoma may progress to completely obstruct the airway. For emergency physicians and trauma surgeons, knowing the typical history and proper treatment, including airway management, for traumatic RH is essential. We could not find a clinical study concerning blunt traumatic RH with respiratory symptoms because the few cases are dispersed among various countries and hospitals. In patients with blunt trauma, 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. Most patients’ symptoms developed within 24 hours of blunt trauma (95.2%), and 73.5% of patients with RH had at least one associated injury. Geriatric patients constituted the largest proportion of patients with RH, and minor trauma was adequate to result in RH in elderly people. Surgery and transarterial embolization are commonly used to control active bleeding in patients with RH. e long-term outcome depends on patients’ associated injuries and in-hospital complications
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