Introduction: Spontaneous Retropharyngeal Hematoma (SRH) is a rare affection which occurs without traumatism.
Case report: A 68 years old woman brought to the emergency department with a cervico-thoracic swelling rapidly increasing in size without any previous traumatic history or anticoagulant medication. Complicated by dysphagia and dysphonia without signs of dyspnea. The clinical examination revealed a painful anterior cervico-thoracic swelling with an ecchymotic cupboard on it. Cervico-thoracic CT scan found a voluminous retro-pharyngeal collection, spontaneously hyperdense, extended to the oropharynx and antero-superior mediastinum without further lesions. Biological assessment was without abnormalities. The diagnosis of retropharyngeal hematoma was retained. The treatment was based on corticosteroids and antibiotics drugs with strict clinical and radiological monitoring. With conservative treatment, the evolution was favorable, marked by progressive regression of the hematoma until its disappearance and an absence of recurrence after a retreat of one year.
Conclusion: The clinical presentation of a retropharyngeal hematoma out of an evocative context is misleading and lead to radiological investigation without delaying the treatment which varies from supervision to surgery according to respiratory status and evolution under strict control.
E C. Fox, V Manchala. Retropharyngeal Hematoma as an Unusual Presentation of Myelodysplastic Syndrome: A Case Report. Am J Case Rep. 2018; 19: 969–972.
Munoz A, Fischbein NJ, De Vergas J. Spontaneous retropharyngeal hematoma: Diagnosis by MR Imaging AJNR. 2001;22:1209-11.
Cohen JI. Spontaneous cervical hemorrhage with near-complete airway obstruction. Head and Neck 1998;20: 350-53
Bapat VN, Brown K, Nakas A. Retropharyngeal hematoma-a rare complication of anticoagulant therapy. Eur.J.Cardio-thoracic Surg.2002;21:117-18.
Vinidh P, Maroju R.S, Ali M.S Spontaneous retro and parapharyngeal haematoma caused by intrathyroid bleed. J. Laryngol. Otol. 2002;116: 854-58.
Tomohiro Yamamoto, MD, PhD; Martin Schmidt-Niemann, Dr. med; Ehrenfried Schindler, Dr. med. A Case of Acute Upper Airway Obstruction in a Pediatric Hemophilia A Patient Because of Spontaneous Retropharyngeal Hemorrhage, annemergmed, Volume 67, Issue 5, pp. 616–619.
Jones TM, Owen GO, Morar P.Spontaneous retropharyngeal haematoma attributable to Ebstein-Barr virus infection.J Laryngol Otol. 1996;110:1075-77.
Armstrong WB, Funk GF, Rice DH. Acute airway compromise secondary to traumatic thyroid hemorrhage Arch Otolaryngol Head Neck Surgery 1994;120:427 30.
Bloom DC, Haegen T, Keefe MA Anticoagulation and spontaneous retropharyngeal hematoma .J. Em Med. 2003;24:389-94.
Senthuran S, Lim S, Gunning KE/ Life-threatening airway obstruction caused by a retropharyngeal haematoma.Anaesthesia 1999;54:674.
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