title: Acute airway obstruction due to retropharyngeal haematoma caused by a large fish bone in a patient with hypertension caused by a pheochromocytoma.
abstract: Retropharyngeal haematoma (RH) is an extremely rare but potentially life-threatening condition that requires an early diagnosis and immediate management. Acute complications arise from compression and obstruction of the upper airway and oesophagus with the risk of consecutive aspiration. We present the case of a 48-year-old man with formation of a RH after accidental ingestion of a large fish bone with hypertension as comorbidity caused by a so far undiagnosed pheochromocytoma. The patient presented with acute onset of retropharyngeal pain, dysphonia and dysphagia secondary to fish bone foreign body ingestion. His medical history was significant for uncontrolled hypertension. CT showed a large RH extending from the oropharynx to the superior mediastinum. The patient underwent emergency tracheostomy, surgical debridement and removal of the fish bone. Antihypertensive medication was utilised to control his labile blood pressure. The postoperative CT scan revealed an adrenal pheochromocytoma that was subsequently resected.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Zhejiang University, The First Affiliated Hospital of Medical School of Zhejiang University, Hang Zhou, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wei
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Linda
authors.initials: L
authors.lastname: Jahreiß
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Zhejiang University, The First Affiliated Hospital of Medical School of Zhejiang University, Hang Zhou, China.
authors.forename: Zhili
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Andreas E
authors.identifier: http://orcid.org/0000-0001-5614-9873
authors.initials: AE
authors.lastname: Albers
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications*; D000402:Airway Obstruction / Q000209:etiology*; D000818:Animals; D001842:Bone and Bones; D003680:Deglutition Disorders / Q000209:etiology; D055154:Dysphonia / Q000209:etiology; D005399:Fishes; D005547:Foreign Bodies / Q000150:complications*; D006406:Hematoma / Q000150:complications* / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009960:Oropharynx; D010608:Pharyngeal Diseases / Q000150:complications* / Q000209:etiology; D010673:Pheochromocytoma / Q000150:complications*