Spontaneous Cervical Hematoma: A Report of Two Cases

• Published in: Ear, nose, & throat journal Vol. 78; no. 3; pp. 168 - 175
• Main Authors: DiFrancesco, Renata C., Escamilla, Jorge S., Sennes, Luiz U., Voegles, Richard L., Tsuji, Domingos H.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.03.1999; Medquest Communications; SAGE PUBLICATIONS, INC
• Subjects: Adult; Aged; Aged, 80 and over; Airway Obstruction - diagnostic imaging; Airway Obstruction - drug therapy; Airway Obstruction - etiology; Anti-Bacterial Agents - therapeutic use; Biological and medical sciences; Female; Hematoma - complications; Hematoma - diagnosis; Hematoma - diagnostic imaging; Hematoma - drug therapy; Humans; Hypertension, Portal - complications; Hypertension, Portal - diagnosis; Male; Medical sciences; Neck; Non tumoral diseases; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Polycythemia Vera - complications; Polycythemia Vera - diagnosis; Schistosomiasis - complications; Schistosomiasis - diagnosis; Tomography, X-Ray Computed; Treatment Outcome; Compression; Upper respiratory tract; Indication; Spontaneous; Cardiovascular disease; Obstruction; Vascular disease; Prevention; Surgery; Blood vessel; ENT disease; Adult; Complication; Female; Neck; Diagnosis; Human; Radiodiagnosis; Case study; Symptomatology; Chemotherapy; Treatment; Hematoma; Medical imagery; Early; Computerized axial tomography; Elderly
• ISSN: 0145-5613; 1942-7522
• DOI: 10.1177/014556139907800310

Cervical hematomas are generally associated with trauma, surgery, and tumors. Although they are rare, they can be life-threatening because they put the patient at risk for great-vessel compression and upper airway obstruction. We describe two cases of spontaneous cervical hematoma—one in an 81-year-old man and the other in a 30-year-old woman. The man reported dysphonia, dysphagia, and neck swelling of 5 hours’ duration. He had been taking 100 mg/day of aspirin for a cardiovascular condition. Examination revealed that the man had polycythemia vera. The woman was found to have neck ache, odynophagia, and cervical ecchymosis; portal hypertension, schistosomiasis, and blood dyscrasia were also found. Both patients denied trauma. A suspected diagnosis of cervical hematoma was confirmed by computed tomography, and treatment was instituted. The hematomas resolved in about 2 weeks. The treatment of cervical hematoma is controversial, although it is agreed that the evaluation of upper airway obstruction and its permeability is mandatory. Surgical treatment is generally reserved for complicated cases because of the risk of infection or bleeding.