Acute Upper Airway Obstruction as Atypical Manifestation of Uncommon Aetiologies- A Case Series

Abstract

Acute upper airway obstruction, an emergent situation, can sometimes put the clinician in a dilemma with no positive history or clinical findings to aid in the diagnosis. A myriad of conditions causes upper airway obstruction. Priority is to secure the airway and then seek out the underlying cause. Computed tomography scan is an important imaging modality for reaching a definitive diagnosis and might at times, reveal unexpected findings. In this case series, authors report three cases of acute upper airway obstruction which were atypical manifestation of diseases. Case 1 (82-year-old male) is about Lemierre’s syndrome with compromised airway in the absence of abscess formation. Case 2 (47-year-old male) depicts an atypical presentation of Boerhaave syndrome as retropharyngeal accumulation of air and pneumomediastinum. Case 3 (67-year-old male) is about retropharyngeal haematoma in a patient with anticoagulant therapy without any definite history of trauma. Treatment with reversal of anticoagulation was successful in the case 3. It is important for the clinician to be aware of the unusual reasons for airway compromise, as early suspicion can translate into better patient survival. Airway should be secured by either intubation or tracheostomy. Many a time, radiological and blood investigations help to arrive at a definite diagnosis.

Keywords

• anticoagulants
• boerhaave syndrome
• esophageal perforation
• haematoma
• lemierre’s syndrome
• venous thrombosis