Conservative treatment of giant spontaneous retropharyngeal hematoma: A case report.

RATIONALE: Spontaneous retropharyngeal hematoma (SRH) is an occult disease that can cause rapid airway obstruction. Currently, no standardized diagnostic and therapeutic protocols have been established. In this case report, we present the successful conservative management of a patient with a giant SRH, further discuss strategies for airway management and hematoma evacuation, and intend to offer practical insights for the diagnosis and management of SRH.

PATIENT CONCERNS: A 54-year-old female patient with rapidly progressive neck swelling and respiratory tract obstruction.

DIAGNOSES: The patient was diagnosed with SRH through computed tomography, magnetic resonance imaging, laryngoscope and ultrasound-guided aspiration biopsy.

INTERVENTIONS: Timely orotracheal intubation, tracheotomy, and anti-infective therapy.

OUTCOMES: After these treatments, the patient successfully had the tracheostomy tube removed after 4 weeks and was discharged from the hospital upon recovery.

LESSONS: This case emphasizes the importance of early identification of SRH. It also highlights that the treatment focus for SRH lies in airway management and the selection of hematoma evacuation protocols. Furthermore, it underscores the need to consider the regularity of hematoma absorption time in the retropharyngeal space, as well as the timing and approach of surgery that should be taken into account when evacuating the hematoma.