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Journal of the Korean Society of Traumatology 2003;16(1):73-77.
Delayed Upper Airway Obstruction Due to Cervical Hematoma after Blunt Neck Trauma in a Patient with Neurofibromatosis
Sang Jin Lee, M.D., Hye Young Jang, M.D., Eun Kyung Eo, M.D., Cheon Young Jin, M.D., Koo Young Jung, M.D.
Department of Emergency Medicine, College of Medicine, Ewha Womans University
신경섬유종증 환자에서 경부 혈종에 의한 지연성 상부 기도 폐쇄 1례
이상진·장혜영·어은경·전영진·정구영
이화여자대학교 의과대학 응급의학교실
Abstract
In a patient with blunt trauma to the neck, there is potential for airway obstruction. In this situation, clinicians must be alert to protect the airway, and rapid assessment and management are essential for saving the life of the patient. A 56-year-old man with neurofibromatosis suffered from a huge, traumatic cervical hematoma following a fall injury. About 43 hours after the injury, he complained of dyspnea, and respiratory failure developed due to the cervical hematoma enlarging. After an emergency cricothyroidotomy, his ventilation was improved. Neck exploration was done, and the culprit vessel - the external carotid artery - was ligated. A high index of suspicion and a serial evaluation for delayed airway complications in neck trauma patients with neurofibromatosis are required because their blood vessels can be genetically fragile to minor trauma. Therefore, ED physicians should know about the management of difficult airways and should not hesitate performing an emergency cricothyroidotomy as a definitive rescue technique for the failed airway.
Key Words: Airway obstruction; Cervical hematoma; Neurofibromatosis; Difficult airway; Cricothyroidotomy


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