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Traumatic retropharyngeal hematoma.

D Myssiorek1, C Shalmi

  • 1Department of Otolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, NY.

Archives of Otolaryngology--Head & Neck Surgery
|September 1, 1989
PubMed
Summary

A rare retropharyngeal hematoma occurred after a whiplash injury in an elderly man on aspirin. Prompt tracheostomy and hematoma drainage were crucial for managing this airway-threatening condition.

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Area of Science:

  • Trauma surgery
  • Emergency medicine
  • Neurosurgery

Background:

  • Retropharyngeal hematomas are rare but can cause life-threatening airway compromise.
  • Whiplash injuries, often from motor vehicle accidents, can rarely lead to this condition.
  • Anticoagulation therapy increases the risk of bleeding complications.

Observation:

  • An 80-year-old male on long-term aspirin developed a retropharyngeal hematoma after a motor vehicle accident.
  • The patient presented with a condition that required immediate medical intervention.
  • Literature review revealed fewer than 20 reported cases of traumatic retropharyngeal hematoma.

Findings:

  • The patient underwent tracheostomy, neck exploration, and hematoma evacuation and drainage.
  • Successful management of the retropharyngeal hematoma was achieved.
  • Associated factors include cervical flexion/extension injuries, anticoagulation, great-vessel trauma, and foreign body ingestion.

Implications:

  • Highlights the importance of rapid assessment and airway management in suspected retropharyngeal hematoma.
  • Underscores the potential for severe complications even from seemingly minor trauma in patients on anticoagulation.
  • Emphasizes the rarity and potential severity of traumatic retropharyngeal hematoma, necessitating high clinical suspicion.

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