title: Retropharyngeal hematoma from parathyroid hemorrhage in a hemodialysis patient.
abstract: A case of a spontaneous retropharyngeal hematoma in a patient on chronic hemodialysis is described. A 75-year-old man presented with a 5-day history of throat discomfort and neck swelling. He had been on hemodialysis for chronic renal failure with secondary hyperparathyroidism. Examination showed a massively enlarged neck and bruising on his left neck and anterior chest. Flexible nasopharyngoscopy revealed bluish bulging of the posterior pharyngeal wall, and CT showed widening of prevertebral soft tissue. Hemodialysis reduced the swelling of the posterior pharyngeal wall, and conservative management including steroids and antibiotics was adequate for managing the airway and hematoma. Retropharyngeal swelling of this patient seemed to be derived not only from the hematoma itself, but also from the lymphatic and venous congestion. Follow-up CT and MRI indicated that the enlarged left parathyroid was the bleeding source. To the best of our knowledge, this is the second report of a retropharyngeal hematoma from parathyroid hyperplasia in a chronic hemodialysis patient. Physicians should be aware that rare parathyroid hemorrhage in chronic hemodialysis patients could lead to airway obstruction by retropharyngeal swelling.
authors: Department of Otorhinolaryngology, Mitsui Memorial Hospital, Tokyo, Japan. g.inokuchi@gmail.com
authors: Go
authors: G
authors: Inokuchi
authors: Nobuhiko
authors: N
authors: Kurita
authors: Miyuki
authors: M
authors: Baba
authors: Yuko
authors: Y
authors: Hata
authors: Taeko
authors: T
authors: Okuno
mesh_terms: D000368:Aged; D006406:Hematoma / Q000150:complications* / Q000000981:diagnostic imaging; D006470:Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D006962:Hyperparathyroidism, Secondary; D006965:Hyperplasia / Q000150:complications* / Q000000981:diagnostic imaging; D007676:Kidney Failure, Chronic / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D010279:Parathyroid Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D010280:Parathyroid Glands / Q000000981:diagnostic imaging / Q000473:pathology; D010608:Pharyngeal Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D006435:Renal Dialysis; D014057:Tomography, X-Ray Computed