Acute spontaneous neck haematoma in children: a rare entity

BACKGROUND: Acute spontaneous neck haematoma is rare in children. This rare type of hematoma occurs abruptly without any preceding trauma or iatrogenic damage, making it very difficult to determine the cause precisely. We report here the first two cases of acute spontaneous neck haematoma presenting with neck swelling, and discuss in this article the diagnosis and treatment strategy in our patients. CASE PRESENTATION: We report a 19-month-old girl and a 30 month-old boy with neck swelling for 10 days. There was no history of trauma, cough, excessive muscular strain or iatrogenic injury, and both patients were not on any anticoagulants or antiplatelet drugs. On initial examination, the swelling was tender, firm and not mobile on palpation. A definite diagnosis was made by hematoma puncture. Both of the haematoma resolved spontaneously in two weeks without any complications or sequelae. CONCLUSIONS: Acute spontaneous neck hematoma in children is a rare disorder without any etiology or precipitating factors. The difficulty in making an early diagnosis is mainly due to the nonspecific presenting symptoms. Conservative management and follow-up is recommended as a choice of treatment.