title: Retropharyngeal hematoma secondary to cervical spine surgery: report of one fatal case.
abstract: A 53-year-old woman suffering from radicular pain due to cervical herniation underwent a spinal surgery consisting of anterior cervical discectomy and fusion with an implantable titanium cage. Five hours after the procedure, the patient developed cervical swelling and dyspnea. An emergency surgery permitted evacuation of a deep cervical hematoma and intubation of the patient, who died some minutes later. The family of the deceased lodged a complaint with the public prosecutor because of unclear circumstances of death. After analysis of the medical records by two forensic pathologists, a medicolegal autopsy was ordered. Massive retropharyngeal and mediastinal hematomas were diagnosed. Pathological study confirmed acute cervical hemorrhage, but failed to detect the source of bleeding. The forensic pathologists concluded that death was due to mechanical asphyxia secondary to pharyngeal compression by the cervical hematoma. To the best of our knowledge, death secondary to retropharyngeal hematoma in this neurosurgical context is rarely encountered.
authors: Service de Médecine Légale, CHU Toulouse-Rangueil, 1 Avenue Professeur Jean Poulhès, Toulouse Cedex 9, 31059, France.
authors: Fabrice
authors: F
authors: Dedouit
authors: Stéphane
authors: S
authors: Grill
authors: Céline
authors: C
authors: Guilbeau-Frugier
authors: Frédéric
authors: F
authors: Savall
authors: Daniel
authors: D
authors: Rougé
authors: Norbert
authors: N
authors: Telmon
mesh_terms: D001237:Asphyxia / Q000209:etiology*; D017586:Diskectomy / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D049429:Forensic Pathology; D006406:Hematoma / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008477:Mediastinal Diseases / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000209:etiology* / Q000473:pathology; D013123:Spinal Fusion / Q000009:adverse effects*
keywords: autopsy; cervical spine surgery; forensic science; mediastinal hemorrhage; medical liability; retropharyngeal hematoma