Internal Medicine, Akiota Hospital, Yamagata-gun, Japan.
Internal Medicine, Akiota Hospital, Yamagata-gun, Japan
BMJ Case Rep. 2021 Mar 22;14(3):e242061. doi: 10.1136/bcr-2021-242061.
Spontaneous pharyngeal haematoma is a rare but life-threatening cause of acute upper airway obstruction, and the clinical manifestation may mimic haemoptysis. A 65-year-old man presented to our emergency department with symptoms of sore throat and haemoptysis. He had no medical history. At arrival, O saturation was 95% on 5 L/min of oxygen with a mask. Results of a blood examination including a coagulation test were normal. Laryngoscopy showed enlargement of the left pharynx and a narrowed airway. Contrast-enhanced CT showed extravascular leakage of contrast medium inside the left pharyngeal haematoma. Fortunately, the haematoma did not lead to airway obstruction, and it decreased spontaneously. We finally diagnosed this case as spontaneous pharyngeal haematoma. When we examine a patient with a symptom of haemoptysis accompanied by sore throat, it is necessary to consider pharyngeal haematoma and to prepare emergency airway protection for acute upper airway obstruction.
自发性咽血肿是一种罕见但危及生命的急性上呼吸道梗阻原因，其临床表现可能类似于咯血。一位 65 岁的男性因咽痛和咯血症状到我院急诊科就诊。他没有既往病史。就诊时，患者佩戴面罩吸氧 5L/min 时血氧饱和度为 95%。凝血试验等血液检查结果正常。喉镜检查显示左咽扩张，气道变窄。增强 CT 显示左咽血肿内有血管外漏造影剂。幸运的是，血肿未导致气道梗阻，且其自发性减小。我们最终诊断该病例为自发性咽血肿。当我们检查有咯血伴咽痛症状的患者时，有必要考虑咽血肿，并为急性上呼吸道梗阻做好紧急气道保护准备。
