Intended for healthcare professionals

Endgames Spot Diagnosis

Management of subacute airway emergency after blunt neck trauma

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j141 (Published 26 January 2017) Cite this as: BMJ 2017;356:j141
  1. Emily Lowe, core surgical trainee,
  2. Sachin Patil, otology and skull base fellow
  1. Southampton General Hospital, Southampton, UK
  1. Correspondence to emily.lowe{at}doctors.org.uk

A 60 year old woman was admitted after a fall, where she sustained a direct trauma to the anterior neck. She had a progressively worsening hoarse voice, difficulty swallowing, and pain with neck movement. The neck was visibly swollen with bruising tracking onto the anterior chest wall. There was no tenderness on palpation of the cervical spine. A lateral radiograph was taken (fig 1). What does the image show?

Fig 1

Answer

The radiograph shows a massive retropharyngeal haematoma, with distortion of the upper aerodigestive tract and loss of normal cervical lordosis.

Discussion

A retropharyngeal haematoma can develop after a minor injury but can cause life threatening compromise of the airway. The aetiology …

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