Abstract
The development of a retropharyngeal hematoma following a trivial blunt trauma is a rare occurrence. A lateral c-spine X-ray or a cervical CT image that shows marked widening of the prevertebral space is sufficient evidence for the clinical diagnosis of retropharyngeal hematoma. When this complication does occur, it can become life-threatening if the airway is compromised. But the diagnosis is obscure and initially veiled in complaints of sore throat or hoarseness, suggesting infection. Thorough investigation of such complaints is necessary especially in patients receiving anticoagulation therapy. We now report a case of retropharyngeal hematoma that occurred as a delayed-onset consequence of a trivial blunt trauma with no evidence of a bony cervical spine injury. It occurred in a 52-year-old man who had been taking warfarin. We also reviewed the literature.
References
1. Rosenbaum L, Thurman P, Krantz SB. Upper airway obstruction as a complication of oral anticoagulation therapy. Report of three cases. Arch Intern Med. 1979. 139:1151–1153.
2. Ha DH, Oh SK. Cervical prevertebral hematoma - a rare complication of acupuncture therapy: a case report. J Korean Soc Spine Surg. 2009. 16:290–293.
3. Daniello NJ, Goldstein SI. Retropharyngeal hematoma secondary to minor blunt head and neck trauma. Ear Nose Throat J. 1994. 73:41–43.
4. al-Fallouji HK, Snow DG, Kuo MJ, Johnson PJ. Spontaneous retropharyngeal haematoma: two cases and a review of the literature. J Laryngol Otol. 1993. 107:649–650.
5. Wholey MH, Bruwer AJ, Baker HL Jr. The lateral roentgenogram of the neck; with comments on the atlanto-odontoid-basion relationship. Radiology. 1958. 71:350–356.
7. O'Donnell JJ, Birkinshaw R, Harte B. Mechanical airway obstruction secondary to retropharyngeal haematoma. Eur J Emerg Med. 1997. 4:166–168.
8. Bapat VN, Brown K, Nakas A, Shabbo F. Retropharyngeal hematoma--a rare complication of anticoagulant therapy. Eur J Cardiothorac Surg. 2002. 21:117–118.
9. Kuhn JE, Graziano GP. Airway compromise as a result of retropharyngeal hematoma following cervical spine injury. J Spinal Disord. 1991. 4:264–269.
10. O'Neill JV, Toomey JM, Snyder GG 3rd. Retropharyngeal hematoma secondary to minor blunt trauma in the elderly patient. J Otolaryngol. 1977. 6:43–46.