Spontaneous retropharyngeal haematoma with direct oral anticoagulant medication.

Munir Abukhder, Jonathan Hulme, Shakira Nathoo, Shubhi Shubhi

BMJ case reports 2021 May 13

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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. © BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Citation

Munir Abukhder, Jonathan Hulme, Shakira Nathoo, Shubhi Shubhi. Spontaneous retropharyngeal haematoma with direct oral anticoagulant medication. BMJ case reports. 2021 May 13;14(5)