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Rare disease
An elderly woman with increasing dyspnoea after a fall
  1. Jens Pfeiffer,
  2. Gerd J Ridder
  1. Department of Otorhinolaryngology – Head and Neck Surgery, University of Freiburg, Freiburg, Germany
  1. Correspondence to Jens Pfeiffer, jens.pfeiffer{at}


An otherwise healthy 92-year-old woman was admitted to our department with shortness of breath and dysphagia 10 h after a fall in her bathroom. Medical checkup at another institution had not uncovered the causation of the complaints. Clinical and radiological examinations at our department then revealed an expanding retropharyngeal and prevertebral haematoma. Because of increasing dyspnoea, a lateral cervical approach was used to remove the haematoma and to achieve haemostasis. The authors could demonstrate that the source of bleeding was a minor injury of the anterior longitudinal ligament. Retropharyngeal haematoma is a potentially life-threatening condition because it can rapidly progress to airway obstruction. Large retropharyngeal haematoma after minor blunt head and neck trauma is not a well-recognised condition. This case, however, illustrates that precarious retropharyngeal haematoma can occur after low-energy trauma even without anticoagulation therapy. A high index of suspicion for this airway collapse is advisable in older patients.

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  • This is a reprint of a paper that first appeared in BMJ Case Reports, BMJ Case Reports 2011; doi:10.1136/bcr.12.2010.3642.

  • Competing interests None.

  • Patient consent Obtained.