Spontaneous neck hematoma in a hemodialysis patient: A case report

We present a 60-year-old maintenance hemodialysis patient who initially presented with neck swelling, which was diagnosed as a thyroid issue. Following a hemodialysis session, the swelling in the neck progressively enlarged, leading to respiratory distress and eventual cardiac arrest. During a life-saving tracheotomy, dark red blood was observed, and endotracheal intubation was urgently performed. Subsequent computed tomography examination identified multiple areas of slight high-density images in the nasopharyngeal cavity, oropharyngeal cavity, and esophagus. As time passed, the patient's hematoma underwent spontaneous absorption, but signs of recovery were absent. We discuss the rarity, etiology, diagnosis, and management of spontaneous neck hematoma in maintenance hemodialysis patients.