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Case Reports
. 2013 Dec 27:8:232.
doi: 10.1186/1749-8090-8-232.

Airway obstruction by a retropharyngeal hematoma secondary to thoracic aortic aneurysm rupture

Hiroshi Kubota  1 , Hidehito Endo, Mio Noma, Hiroshi Tsuchiya, Akihiro Yoshimoto, Yusuke Inaba, Yoshifumi Nishino, Ayaka Tsuboi, Yuki Sato, Naoyuki Kohno
Affiliations
Case Reports

Airway obstruction by a retropharyngeal hematoma secondary to thoracic aortic aneurysm rupture

Hiroshi Kubota et al. J Cardiothorac Surg. .

Abstract

Background: Retropharyngeal hematoma is a rare form of pharyngeal pathology and can present as acute airway obstruction. Among the many causes of retropharyngeal hematoma, thoracic aortic rupture is extremely rare.

Methods and results: A 78-year-old female with airway obstruction by a retropharyngeal hematoma secondary to thoracic aortic aneurysm rupture was successfully treated by total aortic arch replacement and open stent-graft insertion.

Conclusion: Rupture of the thoracic aorta should be considered as a rare but important cause of retropharyngeal hematoma and airway obstruction.

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Figures

Figure 1
Figure 1
Contrast-enhanced computed tomography scans. The larynx was compressed and narrowed by the hematoma. A large cervico-mediastinal hematoma was detected.
Figure 2
Figure 2
Reconstructed contrast-enhanced computed tomography scan. Dense atheromatous change was seen in the thoaracic aorta. A penetrating atherosclerotic ulcer was seen in the distal aortic arch (arrow).
Figure 3
Figure 3
Laryngoscopic findings. The pharyngeal space was narrowed, and the larynx was severely compressed by the hematoma.
Figure 4
Figure 4
Postoperative computed tomography scans. The retropharyngeal hematoma was no longer seen.
Figure 5
Figure 5
Postoperative 3-D reconstructed computed tomography scan. No abnormal vessels or aneurysms were detected in the neck.
See this image and copyright information in PMC

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