2025, Volume 31, Issue 3
SPONTANEOUS RETROPHARYNGEAL HEMATOMA: CASE REPORT
AGNIESZKA WITKOWSKA-JANIK1, ROMAN STABLEWSKI1, ANDRZEJ WOJDAS1
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1Department of Otolaryngology, Military Institute of Aviation Medicine
Autor korenspondencyjny: AGNIESZKA WITKOWSKA-JANIK; Department of Otolaryngology, Military Institute of Aviation Medicine; email: awitkowska@wiml.waw.pl
Streszczenie
Introduction: Retropharyngeal space hematoma is a rare condition that may cause compression of the trachea and esophagus, as well as anterior displacement of the trachea, ultimately posing a risk of acute respiratory failure. The symptoms are often accompanied by subcutaneous hemorrhages on the neck and thorax. It is most often associated with injury to the cervical spine, head, or large vessels. The incidence of hematoma without an identifiable cause (spontaneous) is exceptionally rare and may complicate the diagnostic process.
Case report: A 57-year-old man was transferred from the Emergency Department of another hospital for emergency ENT consultation with a suspected neck phlegmon. Anamnesis included: a 4-day history of fever, increasing difficulty in swallowing, and cough. Three days prior to the hospitalization — there was an episode of severe coughing, sore throat, and progressive increase in the neck circumference. After verification of inflammatory parameters and imaging tests, a retropharyngeal hematoma was diagnosed and conservative treatment was implemented, in the form of antibiotic therapy and intravenous corticosteroid therapy, along with treatment to prevent vascular bleeding. Clinical improvement and gradual resorption of the hematoma were achieved.
Conclusions: The case presented here adds to the increasing number of literature reports concerning retropharyngeal hematomas. Increased clinical vigilance is warranted in patients reporting sudden dysphagia, odynophagia, and dysphonia. Quickly performing imaging tests and properly securing airway patency demonstrate key importance in the management of patients with this condition.
Słowa kluczowe
retropharyngeal hematoma, hemorrhage, neck injury, parapharyngeal space hematoma, tracheostomy