誤吞雞骨導致咽後血腫－病例報告

咽喉血腫在臨床上並不常見。一般多是因頸部外傷或頭部手術後血管出血所造成，因誤食異物導致咽後血腫的病例在文獻中只有2例。本院經例一病例誤食雞骨並嘗試以催吐方式將異物逼出，隔日發現喉嚨痛、吞嚥困難、聲音沙啞及頸部腫大。頸部側面X 光檢查顯示呼吸道受到壓迫且向前移位，而咽後軟組織則明顯增厚。電腦斷成掃描發現咽後部有均質狀物質並向前壓迫到呼吸道。由於病患有呼吸困窘現象，因此我們立即施以氣管切開術，並經由頸部切開移除血腫已及食道鏡取出異物；術後病人症狀緩解，經門診追蹤3個月無任何不適症狀。臨床上對於疑似咽後血腫病人，應以病史、頸部X光及電腦斷層掃描做診斷依據，並排除食道之可性。治療之原則首先要維持呼吸道通暢，在以外科流手術清除血塊，待頸部腫脹減輕後再以食道鏡摘除可能存在之異物。

關鍵字

咽後血腫；食道異物

並列摘要

Retropharyngeal hematoma is a rare complication of blunt nect neck trauma or pharyngeal operations. Only two cases of retorpharyngeal hematoma following accidental ingestion of foreign bodies have been reported. We encountered a 45-year-old man who had a retropharyngeal hematoma after accidentally swallowing a picece of chicken bone. The patient presented with dysphagia, hoarseness, dspnea, as well as swellimg nad tenderness of the neck. Neck An X-ray examination of the neck revealed external compression and anterior shifting of the trachea. Computed tomography of the neck showed a homogeneous mass in the retropharyngeal space. Surgical evacuation of the hematoma via an external approach was perfomed. Then chicken bone was successfully removed with the esophagoscope. The patient recovered without any complication . We emphasizw that airway management is mandatory before commencing definitive surgical procedures in retropharyngeal hematomas.

並列關鍵字

Retropharyngeal lematoma ； esophageal foreign body

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誤吞雞骨導致咽後血腫－病例報告

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