台耳醫誌

Retropharyngeal hematoma is a rare complication following removal of pharyngeal fishbones. It is a potentially life-threatening condition that requires early diagnosis and immediate management to keep the airway. We present a case of an 81-year-old woman with retropharyngeal hematoma formation after removal of a fishbone from her posterior pharyngeal wall. The patient presented with acute onset of neck stiffness and dysphonia 2 hours after removal of the fishbone. A lateral cervical radiography revealed extensive swelling of the retropharyngeal space and a retropharyngeal hematoma was suspected. A transcervical approach for hemostasis was performed but persistent oozing from the surgical wound was noted. Eventually, we used transarterial embolization to control the bleeding. Our experience demonstrated that follow-up lateral cervical radiography after removal of the pharyngeal fishbone is a simple, appropriate way to detect a retropharyngeal hematoma to avoid potentially lethal airway obstruction.
(J Taiwan Otolaryngol Head Neck Surg 2020; 55:85-89)