一名甲状腺结节自发性出血患者发生晕厥。
Syncope in a patient with spontaneous hemorrhage into a thyroid nodule.
作者信息
Sahin Sb, Belice T, Ogullar S, Ayaz T, Cure E
机构信息
> Department of Endocrinology and Metabolism Disease, Recep Tayyip Erdogan University Medical School, Rize, Turkey.
Department of Internal Medicine, Recep Tayyip Erdogan University Medical School, Rize, Turkey.
出版信息
Hippokratia. 2014 Apr;18(2):177-9.
BACKGROUND
Spontaneous hemorrhage into a thyroid nodule occurs exceedingly rare and rarely a neck hematoma can develop. We report a case of syncope due to spontaneous hemorrhage into a thyroid nodule during anticoagulant and antithrombotic therapy.
CASE PRESENTATION
A 64-year-old man was transferred to the emergency department of our hospital because of syncope. His physical examination revealed a 7 x 5 cm hard and painless mass at the left neck region. The neck MRI confirmed a heterogeneous, hyperintense mass in the left lobe of thyroid compressing the trachea and left common carotid artery, internal jugular vein, and vagus nerve bundle. He did not require a surgery in the follow-up. As the hematoma underwent subtotal shrinkage, he remained well without syncope.
CONCLUSION
Hemorrhage into a thyroid nodule should always be considered in patients presenting with neurally mediated syncope.
背景
甲状腺结节自发性出血极为罕见，颈部血肿形成也很少见。我们报告一例在抗凝和抗血栓治疗期间因甲状腺结节自发性出血导致晕厥的病例。
病例介绍
一名64岁男性因晕厥被转至我院急诊科。体格检查发现左侧颈部有一个7×5cm大小的坚硬无痛性肿块。颈部磁共振成像（MRI）证实甲状腺左叶有一个不均匀的高信号肿块，压迫气管、左颈总动脉、颈内静脉和迷走神经束。随访期间他无需手术。随着血肿大部分缩小，他状况良好，未再发生晕厥。
结论
对于出现神经介导性晕厥的患者，应始终考虑甲状腺结节出血的可能性。
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