Park Jin Hoon, Jeong Eui-Kyun, Kang Dong-Ho, Jeon Sang Ryong
Department of Neurological Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
Department of Anesthesiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
J Korean Neurosurg Soc. 2015 Sep;58(3):304-7. doi: 10.3340/jkns.2015.58.3.304. Epub 2015 Sep 30.
Only a few cases of anterior longitudinal ligament (ALL) injury related with retropharyngeal hematoma without fracture have previously been reported. The treatment of choice for retropharyngeal hematoma is generally considered to be conservative care, but we believe that early surgery of this pathology would be better in certain situations. Here, we describe two cases with life-threatening large retropharyngeal hematomas related with ALL injuries and operated on at an early stage. Two previously healthy patients visited the emergency room with neck pain and dyspnea after falling. Serious neck swelling was observed and lateral neck X-ray showed severe widening of the prevertebral space. Due to dyspnea progression, emergency endotracheal intubation was performed. Although there was no primary cause of the retropharyngeal hematoma on preoperative examination, ALL tearing was intraoperatively confirmed during early surgery. The in-hospital evolutions of the patients were favorable after surgery. We should bear in mind the possibility of ALL injury and perform early surgery where possible given the earlier convalescence and good prognosis.
此前仅有少数关于无骨折的咽后血肿相关的前纵韧带（ALL）损伤病例的报道。咽后血肿的首选治疗方法通常被认为是保守治疗，但我们认为在某些情况下对这种病症进行早期手术会更好。在此，我们描述两例与ALL损伤相关的危及生命的巨大咽后血肿并早期接受手术治疗的病例。两名既往健康的患者在跌倒后因颈部疼痛和呼吸困难就诊于急诊室。观察到严重的颈部肿胀，颈部侧位X线显示椎前间隙严重增宽。由于呼吸困难进展，进行了紧急气管插管。尽管术前检查未发现咽后血肿的主要病因，但在早期手术中术中证实存在ALL撕裂。术后患者的院内病情进展良好。我们应牢记ALL损伤的可能性，并在可能的情况下进行早期手术，因为恢复较早且预后良好。
