Abstract
BackgroundRetropharyngeal 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 presentationAn 88-year-old woman slipped and was found prone and was transported to the emergency room. She was alert without any stridor. Physical examination revealed a subcutaneous hematoma in the anterior cervical region. Computed tomography revealed a retropharyngeal hematoma. Angiography and computed tomography angiography showed extravasation from the right costocervical trunk. A radiologist performed trans-arterial embolization, and she had an uneventful course without intubation or developing any complication. She became ambulatory on postoperative day 5.ConclusionAngiography and computed tomography angiography help in early recognition of extravasation in retropharyngeal hematoma, and trans-arterial embolization can help to avoid intubation and its complications.
Highlights
BackgroundThe retropharyngeal space is a broad anatomical space [1]. Between the posterior pharyngeal wall and the vertebral bodies, three potential spaces have been described one of which is the middle space
Retropharyngeal hematoma can cause suffocation if there is delay in securing the airway by intubation
The radiologist placed 4-Frlong sheath in the right femoral artery as an access site, thereafter performed coil embolization (Target XL 360®) (Fig. 2) without sedation. She was admitted to the intensive care unit (ICU) with the following vitals: respiratory rate, 17 breaths/min; peripheral capillary oxygen saturation was 99%; blood pressure, 124/63 mmHg; heart rate, 66 b.p.m.; temperature, 36.5 °C
Summary
The retropharyngeal space is a broad anatomical space [1]. Between the posterior pharyngeal wall and the vertebral bodies, three potential spaces have been described one of which is the middle space. The radiologist placed 4-Frlong sheath in the right femoral artery as an access site, thereafter performed coil embolization (Target XL 360®) (Fig. 2) without sedation She was admitted to the intensive care unit (ICU) with the following vitals: respiratory rate, 17 breaths/min; peripheral capillary oxygen saturation was 99% (in room air); blood pressure, 124/63 mmHg; heart rate, 66 b.p.m.; temperature, 36.5 °C. It took time to adjust the referral, and she was transferred to another hospital for rehabilitation on postoperative day 25 Her vitals at time of discharge were as follows: respiratory rate, 15 breaths/min; peripheral capillary oxygen saturation was 97% (in room air); blood pressure, 108/64 mmHg; heart rate, 66 b.p.m.; temperature, 36.0 °C. She was to refer to a radiologist without follow-up
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