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Case Reports in Endocrinology
Volume 2016, Article ID 4307695, 4 pages
http://dx.doi.org/10.1155/2016/4307695
Case Report

Surgical Management of Life-Threatening Thyroid Haematoma following Occult Blunt Neck Trauma

University Hospital of Wales, Cardiff CF14 4XW, UK

Received 10 July 2016; Accepted 25 September 2016

Academic Editor: Osamu Isozaki

Copyright © 2016 Ronak Ved et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 42-year-old man arrived at the emergency department in severe respiratory distress, requiring immediate intubation and ventilation. An emergency computed tomography (CT) neck scan identified a substantial haematoma within a multinodular goitre, necessitating an emergency total thyroidectomy. It was later discovered that the patient had been the victim of an assault involving blunt trauma to the anterior neck. Five days postoperatively the patient was extubated and was well enough to self-discharge the following day. Pathology revealed the lesion to be a ruptured follicular adenoma within his multinodular goitre. Signs of this rare but life-threatening condition may be subtle on initial presentation, particularly if the patient is obtunded. Patients with suspected blunt neck trauma should be observed for signs of respiratory distress. If this develops, the patient should be intubated to facilitate CT scan, and if thyroid haematoma is confirmed, emergency thyroidectomy is the definitive treatment.