Delayed upper airway obstruction following a retropharyngeal haematoma after minor head trauma.
The development of a retropharyngeal haematoma may occur rarely after major head, face or cervical spine injuries, and it is even less frequent following minor trauma. As these patients are commonly not intubated, a life-threatening upper airway obstruction may occur. We report the case of a man who experienced a late retropharyngeal haematoma with delayed, progressive upper airway obstruction after a minor frontal wound. After an emergency intubation a nuclear magnetic resonance highlighted the magnitude of the bleeding into the retropharynx accounting for the slow onset of the symptoms. Predisposing factors such as antithrombotic therapies and vascular lesions may enhance the risk of occurrence even after minor trauma. Hypotheses on how to identify this potentially fatal complication earlier are reported.
Kette
F
F
Institute of Anaesthesia and Intensive Care Unit, University of Udine, S. Maria della Misericordia Hospital, Italy.
Mergoni
P
P
Girardis
M
M
Sabbadini
D
D
Zauli
M
M
Sussi
L
L
Pasetto
A
A
D000368:Aged; D000402:Airway Obstruction / Q000209:etiology* / Q000628:therapy; D006259:Craniocerebral Trauma / Q000150:complications*; D004638:Emergency Treatment; D006406:Hematoma / Q000150:complications* / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D010608:Pharyngeal Diseases / Q000150:complications* / Q000175:diagnosis / Q000209:etiology; D012307:Risk Factors; D013997:Time Factors; D015599:Trauma Severity Indices