2.A 92-year-old man with retropharyngeal hematoma caused by an injury of the anterior longitudinal ligament.
Seiji MORITA ; Shinichi IIZUKA ; Haruna HIRAKAWA ; Shigeo HIGAMI ; Takeshi YAMAGIWA ; Sadaki INOKUCHI
Chinese Journal of Traumatology 2010;13(2):120-122
Traumatic retropharyngeal hematoma is a rare condition and may be lethal in some cases. In patients with this condition, the absence of a vertebral fracture or a major vascular injury is extremely rare. We present the case of a 92-year-old man who hit his forehead by slipping on the floor in his house. He had no symptoms at the time; however, he experienced throat pain and dyspnea at 6 hours after the injury. On arrival, he complained of severe dyspnea; therefore, an emergency endotracheal intubation was performed. A lateral neck roentgenogram after intubation showed dilatation of the retropharyngeal and retrotracheal space and no evidence of a cervical vertebral fracture. Cervical computed tomography (CT) with contrast medium revealed a massive hematoma extending from the retropharyngeal to the superior mediastinal space but no evidence of contrast medium extravasation or a vertebral fracture. However, sagittal magnetic resonance imaging (MRI) revealed an anterior longitudinal ligament (C4-5 levels) injury. We determined that the cause of the hematoma was an anterior longitudinal ligament injury and a minor vascular injury around the injured ligament. Therefore, we recommend that patients with retropharyngeal hematoma undergo sagittal cervical MRI when roentgenography and CT reveal no evidence of injury.
Aged
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Aged, 80 and over
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Hematoma
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diagnosis
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etiology
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Humans
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Longitudinal Ligaments
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injuries
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Magnetic Resonance Imaging
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Male
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Pharyngeal Diseases
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diagnosis
;
etiology
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Tomography, X-Ray Computed