ENT, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK
ENT, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK.
BMJ Case Rep. 2020 Sep 6;13(9):e237267. doi: 10.1136/bcr-2020-237267.
We present an unusual case of spontaneous cervical haemorrhage secondary to extra-capsular bleeding from a parathyroid adenoma. Signs and symptoms on presentation included sore throat, dysphagia and anterior chest ecchymosis. While CT confirmed active cervical haemorrhage, elevated serum calcium and parathyroid hormone raised suspicion of possible parathyroid pathology. This case report and literature review highlight the diagnostic value of serum calcium in presentations of acute spontaneous neck haematoma. This should be considered especially in the acute phase, where imaging may not identify the source of haemorrhage. Initial observation and deferred surgery is the treatment of choice, with emergency operative management reserved for respiratory distress and worsening compressive symptoms.
我们报告了一例罕见的由甲状旁腺瘤包膜外出血引起的自发性颈部出血病例。就诊时的体征和症状包括咽痛、吞咽困难和前胸瘀斑。CT 证实为活动性颈部出血，血清钙和甲状旁腺激素升高提示可能存在甲状旁腺病变。本病例报告和文献复习强调了血清钙在急性自发性颈部血肿中的诊断价值。在急性阶段，影像学可能无法确定出血源，此时尤其应考虑到这一点。初始观察和延迟手术是首选治疗方法，对于有呼吸窘迫和压迫症状加重的患者，保留紧急手术治疗。
