Yamamoto Tomohiro, Schmidt-Niemann Martin, Schindler Ehrenfried
Department of Pediatric Anesthesiology and Critical Care Medicine, Asklepios Klinik Sankt Augustin, German Pediatric Heart Center, Sankt Augustin, Germany.
Department of Pediatric Anesthesiology and Critical Care Medicine, Asklepios Klinik Sankt Augustin, German Pediatric Heart Center, Sankt Augustin, Germany.
Ann Emerg Med. 2016 May;67(5):616-9. doi: 10.1016/j.annemergmed.2015.08.028. Epub 2015 Oct 3.
We report a rare case of acute upper airway obstruction caused by spontaneous retropharyngeal hemorrhage as a result of hemophilia A in a 16-year-old pediatric patient who routinely received factor VIII replacement. Initial diagnosis was delayed because the patient presented with symptoms, such as throat pain and odynophagia, similar to those of common benign upper airway infections. Within 2 days of the initial presentation of symptoms, the patient went into respiratory failure as a result of retropharyngeal hemorrhage. The possibility of spontaneous retropharyngeal or epiglottic hemorrhage or hematoma should be considered as a cause of rapidly progressing odynophagia and dyspnea by hemophilia patients.
我们报告了一例罕见病例，一名16岁的儿科患者因甲型血友病自发咽后出血导致急性上呼吸道梗阻，该患者常规接受凝血因子VIII替代治疗。由于患者出现咽痛和吞咽痛等症状，与常见的良性上呼吸道感染症状相似，初始诊断有所延迟。在出现症状的2天内，患者因咽后出血而出现呼吸衰竭。血友病患者出现迅速进展的吞咽痛和呼吸困难时，应考虑自发咽后或会厌出血或血肿的可能性。
