J Korean Orthop Assoc.  2010 Oct;45(5):404-407.

Traumatic Retropharyngeal Hematoma of Delayed Onset in an Anticoagulated Patient

• Song KJ
• Song JH
• Lim YJ
• Jeung UO
• Kim KS

Abstract

The development of a retropharyngeal hematoma following a trivial blunt trauma is a rare occurrence. A lateral c-spine X-ray or a cervical CT image that shows marked widening of the prevertebral space is sufficient evidence for the clinical diagnosis of retropharyngeal hematoma. When this complication does occur, it can become life-threatening if the airway is compromised. But the diagnosis is obscure and initially veiled in complaints of sore throat or hoarseness, suggesting infection. Thorough investigation of such complaints is necessary especially in patients receiving anticoagulation therapy. We now report a case of retropharyngeal hematoma that occurred as a delayed-onset consequence of a trivial blunt trauma with no evidence of a bony cervical spine injury. It occurred in a 52-year-old man who had been taking warfarin. We also reviewed the literature.

Keyword

retropharyngeal hematoma; anticoagulation; wafarin

MeSH Terms

Hematoma
Hoarseness
Humans
Middle Aged
Pharyngitis
Spine
Warfarin
Warfarin

Figure

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  Figure 1 (A) Two weeks follow-up radiograph shows an increase of the prevertebral soft tissue distance (about 12.7 mm) at the level of the anteroinferior border of the third cervical vertebra. (B) Initial radiograph shows the prevertebral soft tissue distance less than 5 mm.

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  Figure 2 Sagittal and axial MRIs shows the retropharyngeal hematoma (about 9×3×1.3 cm) extending from C1 to C5.

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  Figure 3 Final follow-up radiograph shows the resolution of hematoma.

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