Báo cáo y học: Spontaneous retropharyngeal haematoma: a case report

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Báo cáo y học: "Spontaneous retropharyngeal haematoma: a case report"Journal of Medical Case Reports BioMed Central Open AccessCase reportSpontaneous retropharyngeal haematoma: a case reportArvind Singh1, Enyi Ofo1 and Vincent Cumberworth*1,2Address: 1Department of Otolaryngology, Northwick Park Hospital, Harrow, UK and 2Imperial College London, London, UKEmail: Arvind Singh - as1ngh@hotmail.com; Enyi Ofo - eofo@hotmail.com; Vincent Cumberworth* - entvlc@aol.com* Corresponding authorPublished: 18 January 2008 Received: 7 July 2007 Accepted: 18 January 2008Journal of Medical Case Reports 2008, 2:8 doi:10.1186/1752-1947-2-8This article is available from: http://www.jmedicalcasereports.com/content/2/1/8© 2008 Singh et al; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction: Spontaneous retropharyngeal haematoma is an unusual condition. It has multiple aetiological factors and can present to a number of specialists including the otolaryngologist. Case presentation: We describe a case of spontaneous retropharyngeal haematoma which demonstrates the dramatic presentation and emphasises the need for a conservative approach. Conclusion: It 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. oropharynx to below the level of the tracheal bifurcationIntroductionRetropharyngeal haematoma is a rare entity with multiple with some tracheal deviation and narrowing. Haemato-aetiological factors. If no cause can be found the condi- logical tests including a clotting screen were normal astion is labelled as spontaneous retropharyngeal hae- well as a barium swallow. An Aortogram performed fivematoma (SRH) [1]. It has been described too infrequently days after the initial presentation was completely normal.to determine the prevalence. This is an alarming condi-tion and although associated with life-threatening com- The condition gradually improved and regression of theplications, often the condition resolves without event. swelling was apparent on a repeat CT scan ten days later, by which time the external bruising had fully settled. AWe describe a case of spontaneous retropharyngeal hae- further CT scan of her chest three months later was com-matoma which demonstrates the dramatic presentation pletely normal and she had no further problems at all overand emphasises the need for a conservative approach. a four year follow up period.Case presentation DiscussionA 61 year old lady presented with a three day history of Retropharyngeal haematoma is associated with a widedysphagia and mild dyspnoea associated with bruising of variety of aetiologies. These include trauma (centralthe neck and front of the chest (Fig. 1). She had no other venous cannulation [2], fishbone impaction [3]), haema-symptoms and signs. Her only medication was a combi- tological issues (anticoagulation [4], Polycythaemianation antihypertensive (atenolol/chlortalidone) and her Rubravera [5], hemophilia [6]), neoplasia [7], Epstein-blood pressure was well controlled throughout. She Barr virus [8], vascular aneurysms [9], parathyroid lesionsdenied any other medication, either self-taken or GP pre- [10]. Spontaneous retropharyngeal haematoma is definedscribed. A CT scan indicated a mass extending from the by the absence of any clear aetiology. ...