Abstract

Fine-needle aspiration biopsy (FNAB) is a procedure completed thousands of times daily across the world as an efficacious and safe way to evaluate thyroid nodules. Complications of an FNAB typically range from patient intolerance to small intrathyroidal hematomas. In rare situations, an FNA may result in significant bleeding leading to airway compromise or significant blood loss. In this case report, a patient underwent an FNAB and developed an arterial bleed leading to an intrathyroidal hematoma and airway compromise requiring intubation. This case report is unique in that it identifies the source of bleeding, exemplifies the complications of a large intrathyroidal hematoma, and describes subsequent treatment of both the arterial bleed and the hematoma.

Highlights

  • Fine-needle aspiration biopsy (FNAB) is a diagnostic modality that has a track record of proven safety, economy, and efficacy for evaluation of thyroid nodules. e procedure is commonly performed in outpatient settings with local anesthetic and a 22 to 27 gauge needle

  • There have been a handful of cases of massive thyroid hematoma after FNAB reported in the literature [5–11]

  • Our group reports a case of significant injury to the superior thyroid artery where the patient was intubated for airway protection. is case is unique in that it identifies the source of the bleeding, which is an example of complications of a large intrathyroidal hematoma, and describes subsequent treatment of both the arterial bleed and the hematoma

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Summary

Introduction

Fine-needle aspiration biopsy (FNAB) is a diagnostic modality that has a track record of proven safety, economy, and efficacy for evaluation of thyroid nodules. e procedure is commonly performed in outpatient settings with local anesthetic and a 22 to 27 gauge needle. Our group reports a case of significant injury to the superior thyroid artery where the patient was intubated for airway protection. One other group did report a thyroid hematoma with a 22-gauge needle that required surgery but not intubation [6].

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