Spontaneous retropharyngeal hemorrhage causing airway obstruction: a case report with a review of the literature.

Spontaneous retropharyngeal hemorrhage, although uncommon, can be rapidly progressive and potentially life-threatening. Timely recognition and appropriate treatment are essential for a successful outcome. We report a case of retropharyngeal hemorrhage in an 81-year-old male with a history of arteriosclerotic disease who presented with cough, dysphagia, dyspnea, and cervical ecchymosis. Lateral plain films and computerized tomography (CT) revealed a diffuse soft tissue density distending the retropharyngeal space and adjacent fascial compartments but sparing the glottic and subglottic airway. Emergency tracheostomy was required to relieve progressive upper airway obstruction. The literature on spontaneous retropharyngeal hematoma is reviewed including clinical presentation, causative factors, and recommended treatment.