Chartier Lucas B, Turner Joel P
Int J Emerg Med. 2010 Jul 8;3(4):431-3. doi: 10.1007/s12245-010-0196-6.
A rare event of a fall causing delayed intrathyroidal hematoma and respiratory distress is reported here. A 75-year-old woman with symptoms of vertigo causing syncope and fall 24 h earlier was seen and discharged from our emergency department after an unremarkable physical exam and 6-h observation period. Within 3 h of discharge, the patient was transported back by Emergency Medical Services with an enlarging neck mass and subjective respiratory distress. CT scan demonstrated a large, expanding hematoma, and the patient underwent an emergency hemithyroidectomy. Hürtle cell adenoma was found on pathologic specimen examination. A review of the literature of similar cases is presented, emphasizing the notion that concurrent thyroid pathology is a risk factor for airway compromise after seemingly benign trauma and that airway compromise can present in a delayed fashion.
本文报道了一例罕见的因跌倒导致甲状腺内延迟性血肿和呼吸窘迫的病例。一名75岁女性，24小时前因眩晕症状导致晕厥和跌倒，在经过体格检查无异常且观察6小时后，从我院急诊科就诊并出院。出院后3小时内，患者因颈部肿块增大和主观呼吸窘迫被紧急医疗服务人员送回。CT扫描显示有一个巨大的、正在扩大的血肿，患者接受了急诊半甲状腺切除术。病理标本检查发现为许特氏细胞腺瘤。本文对类似病例的文献进行了综述，强调了以下观点：并发甲状腺病变是看似良性创伤后气道受损的一个危险因素，并且气道受损可能以延迟的方式出现。
