PMID- 31567991
OWN - NLM
STAT- MEDLINE
DCOM- 20191017
LR  - 20221005
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 98
IP  - 38
DP  - 2019 Sep
TI  - Retropharyngeal hematoma following anterior cervical spine surgery: Lessons from 
      a case report (CARE-compliant).
PG  - e17247
LID - 10.1097/MD.0000000000017247 [doi]
LID - e17247
AB  - RATIONALE: Retropharyngeal hematoma (RH) is an infrequent but potentially 
      life-threatening complication of anterior cervical spine surgeries (ACSS). 
      Challenging situations might be confronted and catastrophic events or even deaths 
      still occurred occasionally during the treatment. Currently, no widely accepted 
      protocol has been developed. PATIENT CONCERNS: A 55 years old male underwent ACSS 
      due to cervical myelopathy. Thirty-three hours after surgery the patient 
      presented cervical swelling and obstructive dysphagia. Conservative treatment 
      resulted in no recovery and cervical swelling progressed. DIAGNOSES: Emergent 
      magnetic resonance imaging and plain radiograph established massive incisional 
      and RHs. RH was shown to extend from the base of the skull to T1. INTERVENTIONS: 
      An emergent surgery was performed under local anesthesia and cervical hematoma 
      was evacuated. Nonetheless, evacuation of the blood clots in the vision field 
      resulted into incomplete recovery of throat blockage. A gloved finger was used to 
      explore the retropharyngeal space and some hidden blood clots were found and 
      evacuated, then the patient obtained complete relief of the symptoms. OUTCOMES: 
      Normal respiration and swallowing functions were obtained after the surgery. 
      Obviously, recovery of motor function was noted while no other complication was 
      found at 3-month follow-up LESSONS:: Our case illustrated that dysphagia was an 
      early symptom of RH. Posterior compression from RH could cause obstruction of the 
      pharyngeal airway and lead to difficulty of intubation. Hematoma could spread 
      through the retropharyngeal space, a hematoma exploration beyond the visual range 
      might be necessary in some cases for fear of the hidden hematoma.
FAU - Ren, Haiyong
AU  - Ren H
AD  - Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou, P.R. 
      China.
FAU - Wang, Jin
AU  - Wang J
FAU - Yu, Leijun
AU  - Yu L
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Cervical Vertebrae/*surgery
MH  - Deglutition Disorders/etiology
MH  - Hematoma/diagnostic imaging/*etiology/surgery
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/diagnosis/diagnostic imaging/etiology
MH  - Radiography
MH  - Spinal Cord Diseases/surgery
PMC - PMC6756692
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2019/10/01 06:00
MHDA- 2019/10/18 06:00
PMCR- 2019/09/20
CRDT- 2019/10/01 06:00
PHST- 2019/10/01 06:00 [entrez]
PHST- 2019/10/01 06:00 [pubmed]
PHST- 2019/10/18 06:00 [medline]
PHST- 2019/09/20 00:00 [pmc-release]
AID - 00005792-201909200-00061 [pii]
AID - MD-D-19-01465 [pii]
AID - 10.1097/MD.0000000000017247 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2019 Sep;98(38):e17247. doi: 10.1097/MD.0000000000017247.