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Retropharyngeal hematoma from parathyroid hemorrhage in a hemodialysis patient.
MedLine Citation:
PMID:  22062399     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
A case of a spontaneous retropharyngeal hematoma in a patient on chronic hemodialysis is described. A 75-year-old man presented with a 5-day history of throat discomfort and neck swelling. He had been on hemodialysis for chronic renal failure with secondary hyperparathyroidism. Examination showed a massively enlarged neck and bruising on his left neck and anterior chest. Flexible nasopharyngoscopy revealed bluish bulging of the posterior pharyngeal wall, and CT showed widening of prevertebral soft tissue. Hemodialysis reduced the swelling of the posterior pharyngeal wall, and conservative management including steroids and antibiotics was adequate for managing the airway and hematoma. Retropharyngeal swelling of this patient seemed to be derived not only from the hematoma itself, but also from the lymphatic and venous congestion. Follow-up CT and MRI indicated that the enlarged left parathyroid was the bleeding source. To the best of our knowledge, this is the second report of a retropharyngeal hematoma from parathyroid hyperplasia in a chronic hemodialysis patient. Physicians should be aware that rare parathyroid hemorrhage in chronic hemodialysis patients could lead to airway obstruction by retropharyngeal swelling.
Authors:
Go Inokuchi; Nobuhiko Kurita; Miyuki Baba; Yuko Hata; Taeko Okuno
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-5
Journal Detail:
Title:  Auris, nasus, larynx     Volume:  -     ISSN:  1879-1476     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708170     Medline TA:  Auris Nasus Larynx     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Otorhinolaryngology, Mitsui Memorial Hospital, Tokyo, Japan.
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