Sugiura Gaku, Takahashi Hiroyuki, Kodama Yoshihisa, Nara Satoshi
Emergency and Critical Care Medical Center, Teine Keijinkai Hospital, 1-jo 12-chome 1-40, Maeda, Teine-ku, Sapporo, 006-8555, Japan.
Department of Radiology, Teine Keijinkai Hospital, Sapporo, Japan.
Int J Emerg Med. 2021 Jan 7;14(1):3. doi: 10.1186/s12245-020-00322-9.
Retropharyngeal hematoma can cause suffocation if there is delay in securing the airway by intubation. However, there are also concerns about complications that can arise with intubation; it is still unknown which cases do not require intubation.
An 88-year-old woman slipped and was found prone and was transported to the emergency room. She was alert without any stridor. Physical examination revealed a subcutaneous hematoma in the anterior cervical region. Computed tomography revealed a retropharyngeal hematoma. Angiography and computed tomography angiography showed extravasation from the right costocervical trunk. A radiologist performed trans-arterial embolization, and she had an uneventful course without intubation or developing any complication. She became ambulatory on postoperative day 5.
Angiography and computed tomography angiography help in early recognition of extravasation in retropharyngeal hematoma, and trans-arterial embolization can help to avoid intubation and its complications.
如果通过插管确保气道安全存在延迟，咽后血肿可导致窒息。然而，对于插管可能出现的并发症也存在担忧；哪些病例不需要插管仍不清楚。
一名88岁女性滑倒后被发现俯卧位，被送往急诊室。她意识清醒，无任何喘鸣。体格检查发现颈前部皮下血肿。计算机断层扫描显示咽后血肿。血管造影和计算机断层扫描血管造影显示右侧肋颈干有造影剂外渗。一名放射科医生进行了经动脉栓塞，她病程顺利，未进行插管，也未出现任何并发症。术后第5天她可下床活动。
血管造影和计算机断层扫描血管造影有助于早期识别咽后血肿中的造影剂外渗，经动脉栓塞有助于避免插管及其并发症。
