A Tough Pill to Swallow- Spontaneous Retropharyngeal Hematoma: A Rare and Unusual Complication of Rivaroxaban Therapy
Ali Naqvi *
UC Irvine Health, 101 City Drive South, Orange CA 92868, USA
Dalia Hawwass
UC Irvine Health, 101 City Drive South, Orange CA 92868, USA
Arnold Seto
VA Long Beach Healthcare systems, 5901 E 7th Street, Long Beach, CA 90822, USA
*Author to whom correspondence should be addressed.
Abstract
Aims: We present the first case of a patient that developed a spontaneous retropharyngeal hematoma as a complication of rivaroxaban therapy.
Case Presentation: A 49-year-old Caucasian male with chronic atrial fibrillation on rivaroxaban presented to the hospital with a rapidly expanding spontaneous retropharyngeal hematoma. He required emergent intubation for airway protection and subsequently was treated with catheter-directed embolization and surgical evacuation.
Discussion: Our report presents a case of a spontaneous retropharyngeal hematoma on rivaroxaban therapy. Unfortunately, most patients with this complication typically present with insidious symptoms including mild neck pain and ear ache, and as a result the diagnosis can easily be overlooked. Therefore, it is of utmost importance that physicians maintain a high index of suspicion, as early recognition and appropriate therapy can reduce morbidity and mortality.
Conclusion: This case highlights a rare but life-threatening hemorrhagic complication of rivaroxaban therapy.
Keywords: Retropharyngeal hematoma, rivaroxaban, atrial fibrillation