title: Acute respiratory distress following fine needle aspiration of thyroid nodule: case report and review of the literature.
abstract: BACKGROUND
  Fine needle aspiration (FNA) is a widely used practice to assess thyroid lesions, with a low morbidity rate. Although neck hematomas following this procedure are quite common, only three cases of massive hemorrhage causing acute airways obstruction have been previously described.
  
  
  METHODS
  We report the case of a 74 years old female with acute respiratory distress following ultrasound-guided FNA for a right paraisthmic thyroid nodule. The patient was admitted to the Emergency Room (ER) 6 hours after the procedure with a large neck hematoma compressing the cervical trachea and requiring surgical decompression. Patient underwent endotracheal intubation followed by isthmectomy and evacuation of the hematoma. Extubation was made 24 hours later in the Intensive Care Unit and the patient was discharged after 48 hours uneventfully.
  
  
  CONCLUSIONS
  Acute thyroid hemorrhage following FNA is very rare but still possible. Prompt intervention is mandatory for patients with rapidly evolving symptoms.
authors.affiliation: General Surgery Unit, Massa Hospital, Massa Carrara, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Donatini
authors.forename: T
authors.initials: T
authors.lastname: Masoni
authors.forename: V
authors.initials: V
authors.lastname: Ricci
authors.forename: M
authors.initials: M
authors.lastname: D'Elia
authors.forename: A
authors.initials: A
authors.lastname: Guadagni
authors.forename: G
authors.initials: G
authors.lastname: Baldetti
authors.forename: M
authors.initials: M
authors.lastname: Viganò
authors.forename: D
authors.initials: D
authors.lastname: Rizzo
authors.forename: G
authors.initials: G
authors.lastname: Manfredini
authors.forename: G
authors.initials: G
authors.lastname: Uggeri
mesh_terms: D000208:Acute Disease; D000368:Aged; D000402:Airway Obstruction / Q000209:etiology* / Q000601:surgery; D044963:Biopsy, Fine-Needle / Q000009:adverse effects*; D005260:Female; D006406:Hematoma / Q000150:complications* / Q000209:etiology / Q000601:surgery; D006801:Humans; D016606:Thyroid Nodule / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome