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Thyroid gland hemorrhage after blunt neck trauma: case report and review of the literature

BACKGROUND: Thyroid hemorrhage is considered to be an uncommon complication following blunt trauma to the neck. This condition is potentially life-threatening due to airway compression and may therefore require emergency airway management and surgical intervention in some cases. CASE PRESENTATION: W...

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Autores principales: Lemke, Johannes, Schreiber, Markus N., Henne-Bruns, Doris, Cammerer, Gregor, Hillenbrand, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5706149/
https://www.ncbi.nlm.nih.gov/pubmed/29183351
http://dx.doi.org/10.1186/s12893-017-0322-y
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author Lemke, Johannes
Schreiber, Markus N.
Henne-Bruns, Doris
Cammerer, Gregor
Hillenbrand, Andreas
author_facet Lemke, Johannes
Schreiber, Markus N.
Henne-Bruns, Doris
Cammerer, Gregor
Hillenbrand, Andreas
author_sort Lemke, Johannes
collection PubMed
description BACKGROUND: Thyroid hemorrhage is considered to be an uncommon complication following blunt trauma to the neck. This condition is potentially life-threatening due to airway compression and may therefore require emergency airway management and surgical intervention in some cases. CASE PRESENTATION: We present the case of a 52-year-old woman who experienced a traumatic thyroid gland rupture (right lobe) with subsequent active arterial bleeding from branches of the inferior thyroid artery. On the same day, the patient presented to our emergency department with a painful swelling of the neck with an inspiratory stridor and hoarseness a few hours after a cycling accident. A right hemithyroidectomy was performed. The postoperative course was uneventful. We identified 33 additional cases published in English literature within the last 30 years, reporting blunt trauma to the neck with hemorrhagic complication of the thyroid gland. We provide a systematic review and particularly consider the aspects of endocrine surgery. CONCLUSION: The treatment approach for patients with blunt thyroid trauma should be dependent on the extent of the thyroid injury. Patients with tracheal compression, active bleeding and increasing hoarseness/shortness of breath require emergency airway control and often surgical exploration for hemorrhage control followed by resection of the ruptured thyroid. Importantly, in contrast to routine thyroid surgery, no electromyographic endotracheal tube is used during emergency intubation. Exchange of an endotracheal tube should be carefully evaluated due to difficult airway management in this setting. For protection against double-sided recurrent nerve palsy and postoperative hypoparathyroidism, a unilateral approach is preferable whenever possible.
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spelling pubmed-57061492017-12-05 Thyroid gland hemorrhage after blunt neck trauma: case report and review of the literature Lemke, Johannes Schreiber, Markus N. Henne-Bruns, Doris Cammerer, Gregor Hillenbrand, Andreas BMC Surg Case Report BACKGROUND: Thyroid hemorrhage is considered to be an uncommon complication following blunt trauma to the neck. This condition is potentially life-threatening due to airway compression and may therefore require emergency airway management and surgical intervention in some cases. CASE PRESENTATION: We present the case of a 52-year-old woman who experienced a traumatic thyroid gland rupture (right lobe) with subsequent active arterial bleeding from branches of the inferior thyroid artery. On the same day, the patient presented to our emergency department with a painful swelling of the neck with an inspiratory stridor and hoarseness a few hours after a cycling accident. A right hemithyroidectomy was performed. The postoperative course was uneventful. We identified 33 additional cases published in English literature within the last 30 years, reporting blunt trauma to the neck with hemorrhagic complication of the thyroid gland. We provide a systematic review and particularly consider the aspects of endocrine surgery. CONCLUSION: The treatment approach for patients with blunt thyroid trauma should be dependent on the extent of the thyroid injury. Patients with tracheal compression, active bleeding and increasing hoarseness/shortness of breath require emergency airway control and often surgical exploration for hemorrhage control followed by resection of the ruptured thyroid. Importantly, in contrast to routine thyroid surgery, no electromyographic endotracheal tube is used during emergency intubation. Exchange of an endotracheal tube should be carefully evaluated due to difficult airway management in this setting. For protection against double-sided recurrent nerve palsy and postoperative hypoparathyroidism, a unilateral approach is preferable whenever possible. BioMed Central 2017-11-28 /pmc/articles/PMC5706149/ /pubmed/29183351 http://dx.doi.org/10.1186/s12893-017-0322-y Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Lemke, Johannes
Schreiber, Markus N.
Henne-Bruns, Doris
Cammerer, Gregor
Hillenbrand, Andreas
Thyroid gland hemorrhage after blunt neck trauma: case report and review of the literature
title Thyroid gland hemorrhage after blunt neck trauma: case report and review of the literature
title_full Thyroid gland hemorrhage after blunt neck trauma: case report and review of the literature
title_fullStr Thyroid gland hemorrhage after blunt neck trauma: case report and review of the literature
title_full_unstemmed Thyroid gland hemorrhage after blunt neck trauma: case report and review of the literature
title_short Thyroid gland hemorrhage after blunt neck trauma: case report and review of the literature
title_sort thyroid gland hemorrhage after blunt neck trauma: case report and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5706149/
https://www.ncbi.nlm.nih.gov/pubmed/29183351
http://dx.doi.org/10.1186/s12893-017-0322-y
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