ABSTRACT
Aims: We present the first case of a patient that developed a spontaneous retropharyngeal hematoma as a complication of rivaroxaban therapy. Case Presentation: A 49-year-old Caucasian male with chronic atrial fibrillation on rivaroxaban presented to the hospital with a rapidly expanding spontaneous retropharyngeal hematoma. He required emergent intubation for airway protection and subsequently was treated with catheterdirected embolization and surgical evacuation. Discussion: Our report presents a case of a spontaneous retropharyngeal hematoma on rivaroxaban therapy. Unfortunately, most patients with this complication typically present with insidious symptoms including mild neck pain and ear ache, and as a result the diagnosis can easily be overlooked. Therefore, it is of utmost importance that physicians maintain a high index of suspicion, as early recognition and appropriate therapy can reduce morbidity and mortality. Conclusion: This case highlights a rare but life-threatening hemorrhagic complication of rivaroxaban therapy.
ABSTRACT
Retroclival epidural hematoma is rare, with fewer than 30 cases reported in the literature. Almost all of the previously reported cases occurred in children, with only a few cases affecting adults. Among these adult patients, only two suffered from the associated occipital condyle fracture (OCF), which is another rare injury. The patient involved in this study suffered from retroclival epidural hematoma and unilateral occipital condyle fracture, as demonstrated on both CT and MRI scans. The patient also suffered from an associated right brachial plexus injury without any other neurological deficits, a condition that has not previously been reported. This paper reviews the underlying mechanisms of these rare injuries and seeks to form an understanding of them before proposing the mechanism of injury in the patient involved in the study
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.
Subject(s)
Humans , Middle Aged , Hematoma , Hoarseness , Pharyngitis , Spine , WarfarinABSTRACT
Retropharyngeal hematoma is a rare, but a life-threatening complication when an internal jugular vein cannulation is performed in a patient with thrombocytopenia and coagulopathy. This report presents the case of a patient with acute airway obstruction that was caused by retropharyngeal hematoma. We discuss the diagnosis, airway management and treatment of this condition.
Subject(s)
Female , Humans , Pregnancy , Airway Management , Airway Obstruction , Catheterization , HELLP Syndrome , Hematoma , Jugular Veins , ThrombocytopeniaABSTRACT
A 73-year-old man with sudden sensory neural hearing loss received a stellate ganglion block. Two hours after the block, the patient complained of newly developed neck discomfort. After an additional two hours, the neck swelled up gradually and neck pain and dyspnea developed. A plain radiograph of neck revealed narrowing of the upper airway; a tracheostomy was performed and the dyspnea was improved. On the next day, the pain site extended to the right scapula and a CT image revealed a huge retropharyngeal hematoma. Hematoma evacuation and bleeder ligation were then performed and the patient was discharged on the fourth day after admission without any complications. A practitioner should always remember to educate the patients about possible complications and undertake intensive observation when performing procedures, even in patients who do not initially present with a compromised airway.