Spontaneous Retropharyngeal Hematoma Research Articles

A novel approach to spontaneous retropharyngeal hematoma—a case report

BackgroundRetropharyngeal hematoma is a rare but life-threatening situation and may require emergency tracheostomy or surgical drainage if the airway is compromised. We present a case of a retropharyngeal hematoma with shown active submucosal bleeding and describe the novel approach taken for compression and control of the hemorrhage.Case presentationA 76-year-old man presented to our institution complaining of dysphagia and pharyngeal discomfort hematoma since that morning. The laryngoscopy showed a hematoma of the posterior wall of the hypopharynx. A computerized tomography scan with contrast was done, demonstrating a collection in the retropharyngeal space, and a small active vessel could be identified.The patient was intubated, and compression was performed in the location of the retropharyngeal hematoma using the esophageal balloon of a Blakemore tube, with successful control of the active bleed.ConclusionsRetropharyngeal hematoma can be fatal, and we present a unique solution that can be used to successfully stop the bleeding while avoiding more invasive strategies, by performing compression with a Blakemore esophageal balloon to stop the bleeding.

Spontaneous Retropharyngeal Space Hematoma: How to Manage?

Introduction: Spontaneous Retropharyngeal Hematoma (SRH) is a rare affection which occurs without traumatism.
 Case report: A 68 years old woman brought to the emergency department with a cervico-thoracic swelling rapidly increasing in size without any previous traumatic history or anticoagulant medication. Complicated by dysphagia and dysphonia without signs of dyspnea. The clinical examination revealed a painful anterior cervico-thoracic swelling with an ecchymotic cupboard on it. Cervico-thoracic CT scan found a voluminous retro-pharyngeal collection, spontaneously hyperdense, extended to the oropharynx and antero-superior mediastinum without further lesions. Biological assessment was without abnormalities. The diagnosis of retropharyngeal hematoma was retained. The treatment was based on corticosteroids and antibiotics drugs with strict clinical and radiological monitoring. With conservative treatment, the evolution was favorable, marked by progressive regression of the hematoma until its disappearance and an absence of recurrence after a retreat of one year.
 Conclusion: The clinical presentation of a retropharyngeal hematoma out of an evocative context is misleading and lead to radiological investigation without delaying the treatment which varies from supervision to surgery according to respiratory status and evolution under strict control.

Retropharyngeal hematoma in the context of obstructive sleep apnea: a case report and review of the literature

BackgroundObstructive sleep apnea is related to increased systemic inflammation and arterial hypertension. We present a case of retropharyngeal hematoma without trauma und hypothesize that this could be caused by untreated obstructive sleep apnea.Case presentationA 47-year-old white woman with unilateral pharyngeal discomfort presented to our ear, nose, and throat clinic. She had no risk factors for the development of a spontaneous retropharyngeal hematoma, for example, hypertension or coagulation disorder. As she was overweight, the anamnesis included signs of obstructive sleep apnea such as snoring or breathing arrests during the night, which she denied. An endoscopic examination showed a submucosal hemorrhage of the posterior wall of her pharynx. Magnetic resonance imaging revealed a retropharyngeal hematoma without evidence of the injury of any blood vessel. A subsequent seven-channel polygraphy revealed a severe obstructive sleep apnea with an apnea-hypopnea index of 59.5 per hour. She was subsequently treated with auto-titrating continuous positive airway pressure resolving obstructive sleep apnea immediately. Two months after this episode she presented without any complaints.ConclusionIn consequence of this case we are convinced that an untreated obstructive sleep apnea can lead to retropharyngeal hematoma.

Spontaneous Retropharyngeal Haematoma: Case Report and Literature Overview

Spontaneous retropharyngeal hematoma is a rare and difficult case to diagnose early. Very few cases have been reported in the literature. We report a rare case of spontaneous retropharyngeal hema-toma presenting with acute onset of neck pain, neck motion limitation and dysphagia. The diagnosis was established by Magnetic Resonance Imaging. The hematoma was drained and the patient condition improved. It is important to be aware of this unusual condition with its distinct presentation. Most cases will resolve with conservative management. Surgical intervention is needed if medical management fails.

Spontaneous retropharyngeal space hematoma: How to manage

Introduction: Spontaneous Retro pharyngeal Hematoma (SRH) is a rare affection which occurs without traumatism. Case report: A 68 years old woman brought to the emergency department with a cervico-thoracic swelling rapidly increasing in size without any previous traumatic history or anticoagulant therapy. Complicated by dysphagia and dysphonia without signs of dyspnea. The clinical examination revealed a painful anterior cervico-thoracic swelling with an ecchymotic cupboard on it. Cervico thoracic CT scan found a voluminous retro-pharyngeal collection, spontaneously hyperdense, extended to the oropharynx and anterosuperior mediastinum without further lesions. Biological assessment was without abnormalities. The diagnosis of retropharyngeal hematoma was retained and the Treatment based on corticosteroids and antibiotics with strict clinical and radiological monitoring. With conservative treatment, the evolution was favorable, marked by progressive regression of the hematoma until its disappearance and an absence of recurrence after a retreat of one year. Conclusion: The clinical presentation of a retropharyngeal hematoma out of an evocative context is misleading and lead to radiological investigation without delaying the treatment which varies from supervision to surgery according to respiratory status and evolution under strict control.

Keep an Eye and an Airway on New Oral Anticoagulants- Spontaneous Retropharyngeal Hematoma in a Patient with Chronic Renal Failure

Keep an Eye and an Airway on New Oral Anticoagulants- Spontaneous Retropharyngeal Hematoma in a Patient with Chronic Renal Failure

Rapidly progressive complete airway obstruction by acute retropharyngeal hematoma

Background: Although Retropharyngeal Hematoma (RPH) has unknown frequency but considered a rare condition which can cause a life threatening airway obstruction. Various precipitating factors have been mentioned as causes of RPH as blunt head or neck trauma, whiplash injury, coagulopathy, central line insertion, stellate ganglion block, sneezing, severe coughing as well as spontaneous RPH. Methods: We report a case of severe life threatening retropharyngeal hematoma secondary to a closed stable C5-C6 fracture that caused severe upper airway obstruction. Results: As the RPH can develop hours or days, even after an apparently minor precipitating injury, in our patient it took almost 3 hours from time of accident till the development of severe upper airway obstruction (picture to be added in main poster). It was such a large collection hematoma that caused severe upper airway obstruction with cannot intubate cannot intubate situation. Conclusion: RPH can cause a mechanical displacement of the pharynx & larynx making securing airway with ETT almost impossible with conventional laryngoscopy or even video-assisted techniques. On the other hand, the time taken for RPH to develop and to cause mechanical obstruction can be limited enough to allow proper preparations as well as availability of fiberoptic technique. We should keep a high index of suspicion of retropharyngeal hematoma and airway involvement in cases of cervical spine fracture, in order to help other physician to increase their awareness and anticipation of such life threatening & meantime avoidable condition. Keywords: retropharyngeal hematoma, airway obstruction

Retropharyngeal Hematoma Secondary to Vomiting in a Healthy Adult: A Case Report

Nontraumatic spontaneous retropharyngeal hematoma is rarely encountered. Clinical diagnosis of retropharyngeal hematoma can be difficult and may be infrequently misdiagnosed with acute pharyngitis. A careful history taking is also an important process to diagnose this disease entity. Because of its rarity and difficulty of early diagnosis, retropharyngeal hematoma may rapidly progress to airway compromise. A 51-year-old woman suddenly developed neck pain and dyspnea after vomiting. Examination showed anterior bulging of the posterior oropharyngeal wall without ecchymosis around neck. No underlying medical conditions, medications, or trauma were found. Cervical magnetic resonance imaging revealed retropharyngeal hematoma collection from nasopharynx to laryngopharynx. We report a case of spontaneous retropharyngeal hematoma with increased intrathoracic pressure caused by vomiting. J Med Cases. 2015;6(2):81-83 doi: http://dx.doi.org/10.14740/jmc2038w

A Tough Pill to Swallow- Spontaneous Retropharyngeal Hematoma: A Rare and Unusual Complication of Rivaroxaban Therapy

Aims: We present the first case of a patient that developed a spontaneous retropharyngeal hematoma as a complication of rivaroxaban therapy. Case Presentation: A 49-year-old Caucasian male with chronic atrial fibrillation on rivaroxaban presented to the hospital with a rapidly expanding spontaneous retropharyngeal hematoma. He required emergent intubation for airway protection and subsequently was treated with catheterdirected embolization and surgical evacuation. Discussion: Our report presents a case of a spontaneous retropharyngeal hematoma on rivaroxaban therapy. Unfortunately, most patients with this complication typically present with insidious symptoms including mild neck pain and ear ache, and as a result the diagnosis can easily be overlooked. Therefore, it is of utmost importance that physicians maintain a high index of suspicion, as early recognition and appropriate therapy can reduce morbidity and mortality. Conclusion: This case highlights a rare but life-threatening hemorrhagic complication of rivaroxaban therapy. Case Study Naqvi et al.; CA, 4(4): 156-159, 2015; Article no.CA.2015.039 157

Retropharyngeal Hematoma Secondary to Vomiting in a Healthy Adult: A Case Report

Nontraumatic spontaneous retropharyngeal hematoma is rarely encountered. Clinical diagnosis of retropharyngeal hematoma can be difficult and may be infrequently misdiagnosed with acute pharyngitis. A careful history taking is also an important process to diagnose this disease entity. Because of its rarity and difficulty of early diagnosis, retropharyngeal hematoma may rapidly progress to airway compromise. A 51-year-old woman suddenly developed neck pain and dyspnea after vomiting. Examination showed anterior bulging of the posterior oropharyngeal wall without ecchymosis around neck. No underlying medical conditions, medications, or trauma were found. Cervical magnetic resonance imaging revealed retropharyngeal hematoma collection from nasopharynx to laryngopharynx. We report a case of spontaneous retropharyngeal hematoma with increased intrathoracic pressure caused by vomiting. J Med Cases. 2015;6(2):81-83 doi: http://dx.doi.org/10.14740/jmc2038w

Spontaneous Retropharyngeal Haematoma in a One-Year-Old Child: A Case Report

Spontaneous retropharyngeal haematoma is an unusual condition and difficult to diagnosis early especially in infants. It has multiple aetiological factors and can present to a number of specialists including the otolaryngologist. We describe an unusual case of a spontaneous huge retropharyngeal haematoma in 1-year-old male child which demonstrates the dramatic presentation and emphasizes the need for immediate surgical approach.

Tracheo-oesophageal compression due to massive spontaneous retropharyngeal haematoma

Spontaneous retropharyngeal haematoma and dissecting intramural haematoma of the oesophagus are two distinct, but rare, phenomena. We describe the first case of complete tracheo-oesophageal obstruction due to spontaneous retropharyngeal haematoma presenting with chest pain and dysphagia. Rapid imaging allowed life-saving transfer to the regional specialist centre, with immediate surgical intervention. The importance, aetiology and clinical features of both diagnoses are discussed.

Retropharyngeal hematoma from parathyroid hemorrhage in a hemodialysis patient

A case of a spontaneous retropharyngeal hematoma in a patient on chronic hemodialysis is described. A 75-year-old man presented with a 5-day history of throat discomfort and neck swelling. He had been on hemodialysis for chronic renal failure with secondary hyperparathyroidism. Examination showed a massively enlarged neck and bruising on his left neck and anterior chest. Flexible nasopharyngoscopy revealed bluish bulging of the posterior pharyngeal wall, and CT showed widening of prevertebral soft tissue. Hemodialysis reduced the swelling of the posterior pharyngeal wall, and conservative management including steroids and antibiotics was adequate for managing the airway and hematoma. Retropharyngeal swelling of this patient seemed to be derived not only from the hematoma itself, but also from the lymphatic and venous congestion. Follow-up CT and MRI indicated that the enlarged left parathyroid was the bleeding source. To the best of our knowledge, this is the second report of a retropharyngeal hematoma from parathyroid hyperplasia in a chronic hemodialysis patient. Physicians should be aware that rare parathyroid hemorrhage in chronic hemodialysis patients could lead to airway obstruction by retropharyngeal swelling.

Spontaneous Retropharyngeal Hematoma - A Case Report -

Spontaneous retropharyngeal hematoma is rare and difficult to diagnosis early. A 23-year-old male spontaneously developed acute onset of neck pain, limitation of neck motion, and mild dysphagia. Magnetic resonance imaging demonstrated blood products in prevertebral space from C2 to C4, suggesting a diagnosis of retropharyngeal hematoma. We report a rare case of spontaneous retropharyngeal hematoma causing neck pain.

A rare case of spontaneous retropharyngeal hematoma presenting as acute respiratory distress in a child

A rare case of spontaneous retropharyngeal hematoma presenting as acute respiratory distress in a child

A rare case of spontaneous retropharyngeal heamatoma presenting as acute respiratory distress in a child

A rare case of spontaneous retropharyngeal haematoma in a 4-year-old child is presented hitherto unreported in the medical literature. The aetiology was spontaneous; clinically the child presented with acute respiratory distress and was successfully managed surgically after securing the airway.

Spontaneous retropharyngeal haematoma: a case report

IntroductionSpontaneous retropharyngeal haematoma is an unusual condition. It has multiple aetiological factors and can present to a number of specialists including the otolaryngologist.Case presentationWe describe a case of spontaneous retropharyngeal haematoma which demonstrates the dramatic presentation and emphasises the need for a conservative approach.ConclusionIt is important to be aware of this unusual condition with its distinct presentation. Surgical intervention should be resisted unless a treatable aetiological factor is found or airway compromise occurs. Most cases will resolve with conservative management.

Spontaneous retropharyngeal hematoma: An unusual presentation of thoracic aortic dissection

A 78-year-old woman presented to the Emergency Department with spontaneous ecchymosis and swelling of the neck. Ecchymosis was also evident on the posterior pharyngeal wall. A lateral soft tissue radiograph demonstrated a retropharyngeal hematoma, which was confirmed by computed tomography (CT). At this time there was no evidence of airway obstruction and she was admitted for observation. One week after admission she became acutely short of breath, and a chest radiograph at this time showed a large pleural effusion. Pleural drainage confirmed this to be a hemothorax. Subsequent CT revealed a thoracic aortic dissection with blood communicating into both the retropharyngeal space and the pleural cavity. The case highlights both an unusual presentation of thoracic aortic dissection, and also the potential for occult hemorrhage in cases of spontaneous retropharyngeal hematoma.