Delayed intrathyroidal hematoma causing respiratory distress after a seemingly benign fall: a case report

A rare event of a fall causing delayed intrathyroidal hematoma and respiratory distress is reported here. A 75-year-old woman with symptoms of vertigo causing syncope and fall 24 h earlier was seen and discharged from our emergency department after an unremarkable physical exam and 6-h observation period. Within 3 h of discharge, the patient was transported back by Emergency Medical Services with an enlarging neck mass and subjective respiratory distress. CT scan demonstrated a large, expanding hematoma, and the patient underwent an emergency hemithyroidectomy. Hürtle cell adenoma was found on pathologic specimen examination. A review of the literature of similar cases is presented, emphasizing the notion that concurrent thyroid pathology is a risk factor for airway compromise after seemingly benign trauma and that airway compromise can present in a delayed fashion.