Korean J Endocr Surg.  2010 Mar;10(1):39-41. 10.16956/kjes.2010.10.1.39.

A Case of Thyroid Hematoma Complicated with Unexpected Airway Obstruction by Blunt Cervical Trauma

• Ra YM
• Lee SE
• Choi IS
• Choi WJ
• Min HS
• Yoon DS

• KMID: 2375732
• DOI: http://doi.org/10.16956/kjes.2010.10.1.39

Abstract

Traumatic thyroid hematoma is a rare problem in cases of blunt trauma, but it can be a life-threatening condition. We report here on a case of thyroid hematoma that was complicated with unexpected airway obstruction due to blunt trauma on the anterior neck. A 23-year-old man who developed neck painful swelling and dyspnea was admitted to the emergency room with a blunt neck injury after motor-bicycle accident, and he hit his anterior neck against the handle-bar. He had no previous thyroid pathology and other medical problems. On the initial examination, his vital signs were stable and the oxygen saturation was 97.8%. A computed tomography (CT) scan of the neck showed fragmentation and extensive hematoma within the right thyroid gland and dislocation of the trachea. No definite bleeding focus was identified on the angiography that was done through the carotid artery. Two hours later, the patient experienced sudden respiratory distress and the oxygen saturation dropped rapidly. The patient needed emerg encyendotracheal intubation and surgical intervention. He successfully underwent right lobectomy of the thyroid gland, and was discharged on the 6th hospital day without any complications. The thyroid function was normal after 3 months.

Keyword

Thyroid hematoma; Trauma; Airway obstruction; Lobectomy

MeSH Terms

Airway Obstruction*
Angiography
Carotid Arteries
Dislocations
Dyspnea
Emergency Service, Hospital
Hematoma*
Hemorrhage
Humans
Intubation
Neck
Neck Injuries
Neck Pain
Oxygen
Pathology
Thyroid Gland*
Trachea
Vital Signs
Young Adult
Oxygen

Figure

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  Fig. 1 A roentgenogram of the neck shows leftward tracheal deviation.

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  Fig. 3 Carotid angiography shows no extravasation.

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  Fig. 2 Computed tomography shows the fragmentation of right thyroid with extensive hematoma and tracheal deviation.

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  Fig. 4 Follow-up computed tomography (after 2 weeks) shows right thyroid lobectomy state and complete resolution of hematoma in right thyroid bed.

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