臨床追突事故後の椎前間隙血腫による気道狭窄例

概要

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Traumatic retropharyngeal hematomas are a rare, but potentially life-threatening emergency requiring an early diagnosis and airway management. We present the case of a 67 year-old man, who was involved in a rear-end collision as a passenger in one of the cars, and was taken to our hospital by ambulance. At first, he complained of only mild cervical pain, and there were no focal neurologic findings. However, he complained of gradual difficulty in swallowing and increasing dyspnea. Five hours after the accident, endotracheal intubation was carried out to maintain the airway. On CT imaging a huge hematoma was revealed in the prevertebral space reaching to the mediastinum. Surgical evacuation of the hematoma and tracheostomy were performed on the 5th day after injury. The patient's postoperative course was uneventful, and he was discharged on the 21st postinjury day. A careful medical history and an appropriate diagnostic approach are essential for the management of such life-threatening situations.