title: Sudden asphyxia caused by retropharyngeal hematoma after blunt thyrocervical artery injury.
abstract: BACKGROUND
  Retropharyngeal hematomas are often associated with blunt cervical spine injury. Generally, they improve with conservative treatment; however, rarely, airway obstruction occurs due to delayed swelling of retropharyngeal hematoma.
  
  
  OBJECTIVE
  To report a case of sudden asphyxia due to retropharyngeal hematoma caused by blunt thyrocervical artery injury.
  
  
  METHODS
  A 30-year-old woman was admitted to the Emergency Department of Tokai University Hospital 4h after injury in a motor vehicle collision. On arrival, she had severe dyspnea and neck swelling; thereafter, a 26-mm-thick retropharyngeal swelling was visualized on lateral cervical plain X-ray study, extending from C1 anterior vertebrae to mediastinum. Emergency intubation was performed for the asphyxia. Because extravasation of contrast agent was observed in the hematoma on emergency contrast-enhanced computed tomography (CT) scan, emergency angiography was performed, from which we diagnosed a hemorrhage from the right thyrocervical artery.
  
  
  CONCLUSIONS
  If a patient with a non-displaced cervical spine injury suffers airway obstruction due to retropharyngeal hematoma, vigorous hemorrhage from a thyrocervical artery injury should be considered as the cause, and emergency contrast-enhanced CT scan of the neck should be performed after emergent tracheal intubation.
authors.affiliation: Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Iizuka
authors.forename: Seiji
authors.initials: S
authors.lastname: Morita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Otsuka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamagiwa
authors.forename: Rie
authors.initials: R
authors.lastname: Yamamoto
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Aoki
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Fukushima
authors.forename: Sadaki
authors.initials: S
authors.lastname: Inokuchi
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D000402:Airway Obstruction / Q000209:etiology* / Q000628:therapy; D001237:Asphyxia / Q000209:etiology* / Q000628:therapy; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries; D004487:Edema / Q000150:complications / Q000209:etiology; D005260:Female; D006406:Hematoma / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007442:Intubation, Intratracheal; D010608:Pharyngeal Diseases / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000150:complications*