Spontaneous retro- and parapharyngeal hematoma caused by anticoagulation therapy: a case report

Abstract

Retropharyngeal, parapharyngeal hematomas are rare but potentially life-threatening conditions that require a prompt diagnosis. Most of the pharyngeal space hematomas described in the literature are associated with complicating factors such as tumour, aneurysm, infection, major cervical spine injury or anticoagulant therapy. We present a case of retropharyngeal, parapharyngeal hematoma, secondary to warfarin use, prescribed for deep vein thrombosis. Patients with pharyngeal space hematoma present a significant management dilemma. It must be considered as an emergency situation, and the main priority should be to secure patient’s airway. A choice between observation, intubation, or a surgical airway intervention should be made by considering the probability of airway obstruction. The treatment of pharyngeal hematoma is conservative in the majority of cases, with close observation. Once symptoms of airway compromise manifest, the airway must be expeditiously secured before complete obstruction occurs.

Keywords

• anticoagulant therapy
• retropharyngeal hematoma
• parapharyngeal hematoma.