Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Mar 22;14(3):e242061.
doi: 10.1136/bcr-2021-242061.

Unusual cause of acute upper airway obstruction: spontaneous pharyngeal haematoma

Kohei Okada  1 , Yuji Okazaki  2 , Toshihisa Ichiba  3 , Yusuke Higashi  1
Affiliations
Case Reports

Unusual cause of acute upper airway obstruction: spontaneous pharyngeal haematoma

Kohei Okada et al. BMJ Case Rep. .

Abstract

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, O2 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.

Keywords: ear; emergency medicine; nose and throat/otolaryngology.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Laryngoscopy showed enlargement of the left pharynx, adhesion of blood and a narrowed airway (A). Contrast-enhanced CT showed extravascular leakage of contrast medium (yellow arrow) inside the left pharyngeal haematoma (B). The yellow arrowhead indicates the superior thyroid artery.
Figure 2
Figure 2
Laryngoscopy (A) and contrast-enhanced CT (B) showed that the left pharyngeal haematoma had disappeared.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Hanashiro N, Yamashiro T, Iraha Y, et al. . Non-Traumatic rupture of the superior thyroid artery with concomitant parathyroid adenoma and multinodular goiter. Acta Radiol Open 2017;6:205846011772281. 10.1177/2058460117722813 - DOI - PMC - PubMed
    1. Bloom DC, Haegen T, Keefe MA. Anticoagulation and spontaneous retropharyngeal hematoma. J Emerg Med 2003;24:389–94. 10.1016/S0736-4679(03)00035-0 - DOI - PubMed
    1. Ditkofsky N, Hanna T. Spontaneous retropharyngeal hematoma. N Engl J Med Overseas Ed 2016;374:e3. 10.1056/NEJMicm1505596 - DOI - PubMed
    1. Eidesheim M, Bouaziz H, François T, et al. . Spontaneous laryngeal haematoma leading to airway obstruction after vaginal delivery. Int J Obstet Anesth 2018;36:137–8. 10.1016/j.ijoa.2018.05.003 - DOI - PubMed
    1. Higgs A, McGrath BA, Goddard C, et al. . Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth 2018;120:323–52. 10.1016/j.bja.2017.10.021 - DOI - PubMed

Publication types