Cardiac arrest with retropharyngeal hematoma caused by minor facial injuries from a ground level fall
Background: Traumatic retropharyngeal hematoma followed by airway obstruction is extremely rare. In this report, we show unique images from two cases of out-of-hospital cardiac arrest due to airway obstruction caused by massive retropharyngeal hematoma after a minor facial injury. Case presentation:...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | Trauma Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352644023001474 |
| _version_ | 1797686827009703936 |
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| author | Takeshi Nishimura Yukihide Nakatani Masafumi Suga Shota Kikuta Keitaro Tada Satoshi Ishihara |
| author_facet | Takeshi Nishimura Yukihide Nakatani Masafumi Suga Shota Kikuta Keitaro Tada Satoshi Ishihara |
| author_sort | Takeshi Nishimura |
| collection | DOAJ |
| description | Background: Traumatic retropharyngeal hematoma followed by airway obstruction is extremely rare. In this report, we show unique images from two cases of out-of-hospital cardiac arrest due to airway obstruction caused by massive retropharyngeal hematoma after a minor facial injury. Case presentation: Case 1: A 78-year-old man was transferred to our emergency department due to cardiac arrest. He presented with respiratory insufficiency after a ground level fall. His neck was swollen, and the attending physician performed an emergent cricothyroidotomy to secure his airway and administered intravenous adrenaline. Computed tomography revealed a massive retropharyngeal hematoma and severe hypoxic encephalopathy. Despite a temporary return of spontaneous circulation (ROSC), the patient died on the admission day.Case 2: A 68-year-old woman presented with dyspnea, prompting her family to call an ambulance. On the way to the hospital, the ambulance crew determined the patient was in cardiac arrest. The patient's history revealed a ground level fall in which she hit her face. Computed tomography revealed a massive retropharyngeal hematoma compressing her upper airway. Although ROSC was obtained, the patient died on the 12th day of hospitalization due to hypoxic encephalopathy.Extension views of cervical spine images identified angular instability without cervical bone fracture in both cases, suggesting that possible injuries of the anterior longitudinal ligament contributed to the retropharyngeal hematoma. Conclusions: Patients presenting with asphyxia after a simple ground level fall accompanied by minor facial injuries should be assessed by emergency physicians for the possibility of a retropharyngeal hematoma. In both cases presented here, unique images indicate possible injuries of the anterior longitudinal ligament. |
| first_indexed | 2024-03-12T01:10:20Z |
| format | Article |
| id | doaj.art-fd268c1b23b74fefa4940fcdf15f0a65 |
| institution | Directory Open Access Journal |
| issn | 2352-6440 |
| language | English |
| last_indexed | 2024-03-12T01:10:20Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Trauma Case Reports |
| spelling | doaj.art-fd268c1b23b74fefa4940fcdf15f0a652023-09-14T04:54:08ZengElsevierTrauma Case Reports2352-64402023-10-0147100899Cardiac arrest with retropharyngeal hematoma caused by minor facial injuries from a ground level fallTakeshi Nishimura0Yukihide Nakatani1Masafumi Suga2Shota Kikuta3Keitaro Tada4Satoshi Ishihara5Corresponding author.; Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, 1-3-1 Wakinohamakaigandori, Chuo-ku, Kobe, Hyogo 651-0073, JapanDepartment of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, 1-3-1 Wakinohamakaigandori, Chuo-ku, Kobe, Hyogo 651-0073, JapanDepartment of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, 1-3-1 Wakinohamakaigandori, Chuo-ku, Kobe, Hyogo 651-0073, JapanDepartment of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, 1-3-1 Wakinohamakaigandori, Chuo-ku, Kobe, Hyogo 651-0073, JapanDepartment of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, 1-3-1 Wakinohamakaigandori, Chuo-ku, Kobe, Hyogo 651-0073, JapanDepartment of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, 1-3-1 Wakinohamakaigandori, Chuo-ku, Kobe, Hyogo 651-0073, JapanBackground: Traumatic retropharyngeal hematoma followed by airway obstruction is extremely rare. In this report, we show unique images from two cases of out-of-hospital cardiac arrest due to airway obstruction caused by massive retropharyngeal hematoma after a minor facial injury. Case presentation: Case 1: A 78-year-old man was transferred to our emergency department due to cardiac arrest. He presented with respiratory insufficiency after a ground level fall. His neck was swollen, and the attending physician performed an emergent cricothyroidotomy to secure his airway and administered intravenous adrenaline. Computed tomography revealed a massive retropharyngeal hematoma and severe hypoxic encephalopathy. Despite a temporary return of spontaneous circulation (ROSC), the patient died on the admission day.Case 2: A 68-year-old woman presented with dyspnea, prompting her family to call an ambulance. On the way to the hospital, the ambulance crew determined the patient was in cardiac arrest. The patient's history revealed a ground level fall in which she hit her face. Computed tomography revealed a massive retropharyngeal hematoma compressing her upper airway. Although ROSC was obtained, the patient died on the 12th day of hospitalization due to hypoxic encephalopathy.Extension views of cervical spine images identified angular instability without cervical bone fracture in both cases, suggesting that possible injuries of the anterior longitudinal ligament contributed to the retropharyngeal hematoma. Conclusions: Patients presenting with asphyxia after a simple ground level fall accompanied by minor facial injuries should be assessed by emergency physicians for the possibility of a retropharyngeal hematoma. In both cases presented here, unique images indicate possible injuries of the anterior longitudinal ligament.http://www.sciencedirect.com/science/article/pii/S2352644023001474Retropharyngeal spaceTraumaAirway obstructionRespiratory failure |
| spellingShingle | Takeshi Nishimura Yukihide Nakatani Masafumi Suga Shota Kikuta Keitaro Tada Satoshi Ishihara Cardiac arrest with retropharyngeal hematoma caused by minor facial injuries from a ground level fall Trauma Case Reports Retropharyngeal space Trauma Airway obstruction Respiratory failure |
| title | Cardiac arrest with retropharyngeal hematoma caused by minor facial injuries from a ground level fall |
| title_full | Cardiac arrest with retropharyngeal hematoma caused by minor facial injuries from a ground level fall |
| title_fullStr | Cardiac arrest with retropharyngeal hematoma caused by minor facial injuries from a ground level fall |
| title_full_unstemmed | Cardiac arrest with retropharyngeal hematoma caused by minor facial injuries from a ground level fall |
| title_short | Cardiac arrest with retropharyngeal hematoma caused by minor facial injuries from a ground level fall |
| title_sort | cardiac arrest with retropharyngeal hematoma caused by minor facial injuries from a ground level fall |
| topic | Retropharyngeal space Trauma Airway obstruction Respiratory failure |
| url | http://www.sciencedirect.com/science/article/pii/S2352644023001474 |
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