Hara Hirotaka, Hirose Yoshinobu, Yamashita Hiroshi
Department of Otolaryngology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
BMC Res Notes. 2016 Feb 19;9:114. doi: 10.1186/s13104-016-1932-7.
Thyroid rupture following blunt trauma is extremely rare, and neck pain without swelling may be the only presenting symptom. However, hemorrhage and hematoma subsequently causes severe tracheal compression and respiratory distress.
A 71-year-old Japanese woman visited our emergency room with a complaint of increasing right-sided neck pain at the thyroid cartilage level after she tripped and accidentally hit her neck against a pole 3 h back. On admission, her vital signs were stable. There was no swelling or subcutaneous emphysema. Laryngeal endoscopy revealed mild laryngeal edema, although there was no impairment in vocal fold mobility on either side. Contrast-enhanced computed tomography (CT) revealed rupture of the right lobe of the thyroid gland accompanied by a large hematoma extending from the neck to the mediastinum. Under general anesthesia, the right lobe was resected and the hematoma was evacuated.
Only a few isolated cases of thyroid rupture caused by blunt neck trauma have been reported in patients with normal thyroid glands and neck pain without swelling may be the only presenting symptom. When suspected, CT should be performed to confirm the diagnosis determine the optimal treatment.
钝性创伤后甲状腺破裂极为罕见，颈部疼痛而无肿胀可能是唯一的表现症状。然而，出血和血肿随后会导致严重的气管压迫和呼吸窘迫。
一名71岁的日本女性因3小时前绊倒并意外将颈部撞到柱子后，甲状腺软骨水平右侧颈部疼痛加剧而前来我们的急诊室就诊。入院时，她的生命体征稳定。没有肿胀或皮下气肿。喉镜检查显示轻度喉水肿，尽管双侧声带活动均无受损。增强计算机断层扫描（CT）显示甲状腺右叶破裂，伴有一个从颈部延伸至纵隔的大血肿。在全身麻醉下，切除右叶并清除血肿。
在甲状腺正常的患者中，仅有少数因钝性颈部创伤导致甲状腺破裂的孤立病例报告，颈部疼痛而无肿胀可能是唯一的表现症状。怀疑时，应进行CT检查以确诊并确定最佳治疗方案。
