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Postoperative Cervical Soft Tissue Hemorrhage with Acute Upper Airway Obstruction

NCJ Number
243716
Journal
Journal of Forensic Sciences Volume: 58 Issue: S 1 Dated: January 2013 Pages: S 264-S 266
Author(s)
Esther Quick, M.B., B.S.; Roger W. Byard, M.D.
Date Published
January 2013
Length
3 pages
Annotation
Two cases are reported following cervical surgery where stridor, respiratory distress, and lethal airway occlusion resulted from hemorrhage that did not arise from large vessels
Abstract
Cervical surgery may be complicated by acute upper airway obstruction due to hematoma formation. Two cases are reported following cervical surgery where stridor, respiratory distress, and lethal airway occlusion resulted from hemorrhage that did not arise from large vessels. Case 1: A 50-year-old man who had an elective anterior fusion of C5-6 vertebrae developed marked neck swelling and stridor. At autopsy, there was significant cervical interstitial hemorrhage and edema. Major vessels were intact. Case 2: An 86-year-old man who underwent a carotid endarterectomy developed stridor and swelling of his neck. At autopsy, there was extensive interstitial hemorrhage and edema within the soft tissues of the neck. The endarterectomy site was intact. Both deaths were due to upper airway obstruction from postoperative cervical interstitial hemorrhage with no large vessel damage identified. Hemorrhage from small vessels may therefore lead to critical soft tissue hematoma formation and edema with airway obstruction and death. Abstract published by arrangement with John Wiley & Sons.