Spontaneous intrathyroidal hematoma causing airway obstruction

a case report

Corliss A. E. Best, Sandeep Dhaliwal, Samantha Tam, T. Hubert Low, Brian Hughes, Kevin Fung, S. Danielle MacNeil*

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Citations (Scopus)
1 Downloads (Pure)

Abstract

Introduction: Spontaneous thyroid hemorrhage is a rare occurrence that results in pain, discomfort, and occasionally compressive symptoms. Infrequently, extensive thyroid hemorrhage can result in a rapidly expanding hematoma resulting in airway compromise. This is a case of an otherwise healthy young woman, 3 months postpartum, with a slowly expanding spontaneous thyroid hemorrhage that measured at 7×5.5×5cm by computed tomography. She ultimately required intubation to manage respiratory distress and subsequently a hemithyroidectomy for definitive treatment. The case presentation is followed by a literature review where known etiologies of thyroid hematoma including traumatic and nontraumatic causes, precipitating anticoagulation, and spontaneous rupture of branches of the external carotid artery are outlined. The potential links to pregnancy are explored. The roles of bedside thyroid ultrasound in the emergency department and lateral neck roentgenogram in diagnosis are explored. The importance of airway management and indications for conservative versus surgical treatments are discussed. Conclusions: This is a case of a spontaneous intrathyroidal hemorrhage, which progressed over days to ultimately cause airway compromise. It is imperative that physicians are educated on the appropriate detection and management of the potentially lifethreatening spontaneous thyroid hematoma.

Original languageEnglish
Article numbere3209
Pages (from-to)1-4
Number of pages4
JournalMedicine (United States)
Volume95
Issue number35
DOIs
Publication statusPublished - Aug 2016
Externally publishedYes

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Bibliographical note

Copyright the Author(s) 2016. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • Airway obstruction
  • Spontaneous thyroid bleed
  • Thyroid hematoma
  • Thyroid hemorrhage

Cite this

Best, C. A. E., Dhaliwal, S., Tam, S., Low, T. H., Hughes, B., Fung, K., & MacNeil, S. D. (2016). Spontaneous intrathyroidal hematoma causing airway obstruction: a case report. Medicine (United States), 95(35), 1-4. [e3209]. https://doi.org/10.1097/MD.0000000000003209