Presentation
Presented to ED two weeks after a right hemithyroidectomy with progressive neck swelling. Marked dysphagia and anxious when lying flat. On warfarin.
Patient Data
There is a large collection representing hematoma/clot within the visceral space of the neck at the site of the right hemithyroid resection cavity.
Hyperdensity anteriorly may suggest more acute hemorrhage.
The hematoma laterally displaces the common carotid artery and internal jugular artery and causes medial displacement of the trachea. The right common carotid artery and internal jugular vein remain widely patent and the tracheal lumen is not narrowed.
A locule gas is present superiorly within the collection.
Case Discussion
The patient underwent surgery the following day. A large hematoma posterior to the strap muscles was evacuated.
Hematoma following thyroid surgery is a rare but life-threatening complication. Most hemorrhages occur within 24 hours of surgery.
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