Sudden Asphyxia Caused by Retropharyngeal Hematoma after Blunt Thyrocervical Artery Injury

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• 作者：Shinichi Iizuka ; Seiji Morita ; Hiroyuki Otsuka ; Takeshi Yamagiwa ; Rie Yamamoto ; Hiromichi Aoki ; Tomokazu Fukushima ; Sadaki Inokuchi
• 关键词：retropharyngeal hematoma ; cervical spine injury ; blunt cervical artery injury ; thyrocervical artery injury ; blunt trauma
• 刊名：Journal of Emergency Medicine
• 出版年：2012
• 出版时间：September, 2012
• 年：2012
• 卷：43
• 期：3
• 页码：451-456
• 全文大小：658 K

文摘

Background

Retropharyngeal hematomas are often associated with blunt cervical spine injury. Generally, they improve with conservative treatment; however, rarely, airway obstruction occurs due to delayed swelling of retropharyngeal hematoma.

Objectives

To report a case of sudden asphyxia due to retropharyngeal hematoma caused by blunt thyrocervical artery injury.

Case Report

A 30-year-old woman was admitted to the Emergency Department of Tokai University Hospital 4 h after injury in a motor vehicle collision. On arrival, she had severe dyspnea and neck swelling; thereafter, a 26-mm-thick retropharyngeal swelling was visualized on lateral cervical plain X-ray study, extending from C1 anterior vertebrae to mediastinum. Emergency intubation was performed for the asphyxia. Because extravasation of contrast agent was observed in the hematoma on emergency contrast-enhanced computed tomography (CT) scan, emergency angiography was performed, from which we diagnosed a hemorrhage from the right thyrocervical artery.

Conclusion

If a patient with a non-displaced cervical spine injury suffers airway obstruction due to retropharyngeal hematoma, vigorous hemorrhage from a thyrocervical artery injury should be considered as the cause, and emergency contrast-enhanced CT scan of the neck should be performed after emergent tracheal intubation.