Thyroid gland hemorrhage after blunt neck trauma: case report and review of the literature
| Autor: | Doris Henne-Bruns, Andreas Hillenbrand, Markus Schreiber, Gregor Cammerer, Johannes Lemke |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Blunt neck trauma medicine.medical_treatment lcsh:Surgery Case Report Hemorrhage Wounds Nonpenetrating 03 medical and health sciences 0302 clinical medicine medicine.artery medicine Humans Intubation Inferior thyroid artery Rupture business.industry Thyroid 030208 emergency & critical care medicine lcsh:RD1-811 General Medicine Emergency department Middle Aged Thyroid Diseases Surgery Endocrine surgery Thyroid gland hemorrhage medicine.anatomical_structure Blunt trauma 030220 oncology & carcinogenesis Anesthesia Thyroidectomy Female Airway management business Airway |
| Zdroj: | BMC Surgery BMC Surgery, Vol 17, Iss 1, Pp 1-5 (2017) |
| ISSN: | 1471-2482 |
| DOI: | 10.1186/s12893-017-0322-y |
| Popis: | Background Thyroid hemorrhage is considered to be an uncommon complication following blunt trauma to the neck. This condition is potentially life-threatening due to airway compression and may therefore require emergency airway management and surgical intervention in some cases. Case presentation We present the case of a 52-year-old woman who experienced a traumatic thyroid gland rupture (right lobe) with subsequent active arterial bleeding from branches of the inferior thyroid artery. On the same day, the patient presented to our emergency department with a painful swelling of the neck with an inspiratory stridor and hoarseness a few hours after a cycling accident. A right hemithyroidectomy was performed. The postoperative course was uneventful. We identified 33 additional cases published in English literature within the last 30 years, reporting blunt trauma to the neck with hemorrhagic complication of the thyroid gland. We provide a systematic review and particularly consider the aspects of endocrine surgery. Conclusion The treatment approach for patients with blunt thyroid trauma should be dependent on the extent of the thyroid injury. Patients with tracheal compression, active bleeding and increasing hoarseness/shortness of breath require emergency airway control and often surgical exploration for hemorrhage control followed by resection of the ruptured thyroid. Importantly, in contrast to routine thyroid surgery, no electromyographic endotracheal tube is used during emergency intubation. Exchange of an endotracheal tube should be carefully evaluated due to difficult airway management in this setting. For protection against double-sided recurrent nerve palsy and postoperative hypoparathyroidism, a unilateral approach is preferable whenever possible. |
| Databáze: | OpenAIRE |
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