Retropharyngeal hematoma with a widened mediastinum: Following cough and sneezing after influenza

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Retropharyngeal hematoma with a widened mediastinum is a very rare disease and may progress rapidly and cause airway obstruction. We report an case of a 85-year-old woman with acute onset of neck pain and swelling after sneezing. She received anticoagulation therapy. X-ray and computerized tomography of the neck and chest was performed. This revealed intact great vessels with no evidence of dissection of the aorta and a retropharyngeal hematoma extending from the epipharynx to mediastinum that was compressing the airway. The patient required endonasal intubation by using a flexible fiberscope. Evacuation of the hematoma was carried out under general anesthesia via the cervical approach. Tracheostomy was performed and a corrugated drain was placed in the retropharyngeal space. The patient recovered well after surgery.
特定非営利活動法人日本頭頸部外科学会の論文