A 69‐year‐old man, with no prescribed anticoagulants or antiplatelets, was admitted to our hospital after a high‐impact motor vehicle accident. He complained of right‐sided chest pain. He was driving while wearing a seatbelt, and the airbag deployed. On admission, he was alert with no respiratory distress or airway obstruction. Physical examination revealed right‐sided chest wall tenderness with slightly positive “seatbelt sign.” Contrast‐enhanced computed tomography showed a hematoma (Fig. (Fig.1,1, arrows) in the retrotracheal space with contrast medium extravasation (Fig. (Fig.1,1, arrowheads) during the delayed phase without spinal fractures (Fig. (Fig.1A,1A, axial and Fig. Fig.1B,1B, sagittal). Traumatic retropharyngeal–posterior mediastinal hematoma (caused by venous injury) was diagnosed. We carried out tracheal intubation, and a repeat computed tomography scan showed a reduced hematoma size. Upper gastrointestinal endoscopy showed no signs of esophageal injury. The patient was successfully extubated on day 3.
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