Neck hematoma caused by spontaneous hemorrhage of thyroid: Experience Sharing and Literature Review

摘要

Spontaneous hematoma of the neck is rare, but it can endanger life. There are a variety of causes, including aneurysm, infection, the rupture and bleeding of the thyroid and paratha-yroid tumor. The clinical symptoms include swelling of the neck, displacement of the trachea, subcutaneous congestion in the pharynx and neck, severe dyspnea and even asphyxia. Due to the particularity of the anatomical structure of the neck, the hematoma can develop to airway pressure and even life threatening in hours to days. The clinical course was usually divided into two steps, initially with limited extravasation of the blood and then suddenly expanding to the whole neck to make it difficult to breathe. It is rare for the cervical hematoma and asphyxia caused by spontaneous hemorrhage of the thyroid gland. Only 30 cases have been reported in the relevant literature. In this paper, a case of emergency surgical treatment for the cervical hematoma and dyspnea caused by the thyroid gland was introduced, and related literature was reviewed and summarized. We summarizeed the experience reported in the literature, and drew the following conclusions. The incidence of spontaneous neck hematoma was the same on the left side as right side, the majority patient were elderly people. The average age was 62 years old, and there were more women than men. There was a certain correlation between thyroid spontaneous bleeding and the underlying thyroid diseases. The thyroid artery aneurysm was the common etiology, among which the most common was the inferior thyroid artery aneurysms. The survival rate of positive surgery or embolization was higher than that of conserveative observation.