Spontaneous retropharyngeal haematoma with direct oral anticoagulant medication.
Abukhder, Munir Hulme, Jonathan Nathoo, Shakira Shubhi, Shubhi
Abukhder, Munir
Hulme, Jonathan
Nathoo, Shakira
Shubhi, Shubhi
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Sandwell and West Birmingham NHS Trust; Prince Charles Hospital
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Publication date
2021-05-13
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Abstract
A 79-year-old man presented to the emergency department following a 1-week history of dyspnoea, dysphonia, dysphagia and a nonproductive cough. Previous medical history included atrial fibrillation, for which he was taking rivaroxaban, hypertension and obstructive sleep apnoea. On assessment, there was a mild stridor, swelling of the anterior aspect of the neck and submandibular bruising. CT of the neck demonstrated prevertebral soft tissue swelling extending from C1 to C6 levels, approximately 88 mm in length with a maximum depth of 25 mm. A diagnosis of spontaneous retropharyngeal haematoma was made: the airway was secured with fibreoptic nasal intubation and the patient admitted to the intensive care unit. Direct and fibreoptic assessment of the airway on day 3 confirmed that the haematoma had significantly reduced in size. The patient was extubated on day 4 and made a good recovery.
Citation
Abukhder M, Hulme J, Nathoo S, Shubhi S. Spontaneous retropharyngeal haematoma with direct oral anticoagulant medication. BMJ Case Rep. 2021 May 13;14(5):e240369. doi: 10.1136/bcr-2020-240369.
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