Successful management of retropharyngeal hematoma by trans-arterial embolism without intubation

• Main Authors: Gaku Sugiura, Hiroyuki Takahashi, Yoshihisa Kodama, Satoshi Nara
• Format: Article
• Language: English
• Published: BMC 2021-01-01
• Series: International Journal of Emergency Medicine
• Subjects: Computed tomography angiography; Intubation; Hematoma; Embolization
• Online Access: https://doi.org/10.1186/s12245-020-00322-9

Abstract Background 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. Case presentation 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. Conclusion 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.