Vieitez Verónica, Martín-Cuervo María, López-Ramis Víctor, Ezquerra Luis Javier
Veterinary Teaching Hospital, University of Extremadura, Avda, Universidad s/n, Cáceres, 10003, Spain.
BMC Vet Res. 2015 Oct 9;11:257. doi: 10.1186/s12917-015-0574-7.
Retropharyngeal hematoma is a rare condition that is difficult to diagnose and may progress rapidly to airway obstruction. The authors report the first known case of acute upper airway obstruction resulting from retropharyngeal hematoma in a dog. Documented causes in human medicine have included coagulopathic states, trauma, infection, parathyroid adenoma rupture, and foreign body ingestion. Vague symptoms in humans such as sore throat, shortness of breath, dysphonia, dysphagia, and neck swelling may precede lethal airway obstruction.
The authors report a case of an 18-month-old, intact female water spaniel with thrombocytopenia that developed a massive retropharyngeal hematoma and symptoms of airway compromise. The dog required tracheal intubation followed by surgical tracheostomy. Lateral cervical radiography and magnetic resonance imaging of the neck was consistent with a retropharyngeal hematoma compromising the airway. The retropharyngeal hematoma was managed conservatively.
Retropharyngeal hematoma should be considered in patients presenting with abrupt respiratory distress. Magnetic resonance imaging allowed specific diagnosis of a rare condition that is otherwise difficult to diagnose.
咽后血肿是一种罕见疾病，难以诊断，且可能迅速发展为气道阻塞。作者报告了首例已知的犬因咽后血肿导致急性上气道阻塞的病例。医学文献记载的病因包括凝血功能障碍、外伤、感染、甲状旁腺腺瘤破裂和异物摄入。人类出现的如咽痛、呼吸急促、声音嘶哑、吞咽困难和颈部肿胀等模糊症状可能先于致命的气道阻塞出现。
作者报告了一例18月龄、未绝育的雌性水猎犬，患有血小板减少症，出现了巨大的咽后血肿和气道受损症状。这只狗需要气管插管，随后进行手术气管切开术。颈部侧位X线摄影和磁共振成像显示与压迫气道的咽后血肿相符。咽后血肿采用保守治疗。
对于出现突发呼吸窘迫的患者应考虑咽后血肿。磁共振成像能够对这种罕见且难以诊断的疾病进行特异性诊断。
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