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Traumatische Schilddrüsenruptur: Fallbericht und Literaturübersicht

Traumatic thyroid rupture: case report and review of the literature

  • fallbericht
  • Published:
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Zusammenfassung

Hintergrund

Traumatische Rupturen der Schilddrüse sind eine Seltenheit. Ein einheitliches therapeutisches Vorgehen gibt es nicht. Es liegen konservative und operative Behandlungstrategien vor.

Methode

Diese Arbeit beschreibt den Fall einer Schilddrüsenruptur unter Berücksichtigung der aktuellen Literatur. Anschließend wird der aktuelle Fall in die Datenlage eingearbeitet. Eine vorliegende Klassifikation wird überarbeitet, um daraus einen Behandlungsvorschlag zu entwickeln.

Ergebnisse

Insgesamt sind bisher 34 beschriebene Schilddrüsenrupturen veröffentlicht, die je zur Hälfte operiert oder konservativ überwacht wurden. Keiner der Patienten verstarb an seiner Verletzung. Bei 59 % der Fälle lag eine Schilddrüsenpathologie vor. Die Ursache von 17 der beschriebenen Rupturen war ein Verkehrsunfall.

Schlussfolgerung

Die überarbeitete Klassifikation und der hier entwickelte Behandlungsvorschlag stellt einen klinisch-praktikablen Ansatz vor.

Summary

Background

Traumatic rupture of the thyroid gland is rare. A common approach does not exist. Surgical and nonsurgical management have been advocated.

Method

This work summarizes the publications in PubMed including an own case. This study will analyse the accident mechanism, the underlying thyroid pathologies, possible pathogenetic mechanisms of airway obstruction and the therapeutic options. A present classification is revised in order to develop it into a treatment proposal.

Results

A total of 34 case reports were analysed. The first half had to be performed a surgery on, the other half was observed without surgical treatment. None of the patients died of his injury. 59 % of the patients, that had to be performed a surgery on had thyroid pathology before rupture. 50 % of all patients had a road accident as a cause for the rupture.

Conclusion

The revised classification and treatment proposal developed here presents a clinically-viable approach.

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Literatur

  1. Ahrens J, Jüttner B, Heidt S, et al. Thyroid gland rupture: a rare case of respiratory distress. J Emerg Med. 2012;43:41–3.

    Article  PubMed  Google Scholar 

  2. Heizmann O, Schmid R, Oertli D. Blunt injury to the thyroid gland: proposed classification and treatment algorithm. J Trauma. 2006;61:1012–5.

    Article  PubMed  Google Scholar 

  3. Park CH, Oh KK, Kim EK, et al. Thyroid gland rupture after blunt cervical trauma. J Ultrasound Med. 2006;25:943–6.

    PubMed  Google Scholar 

  4. Chartier LB, Turner JP. Delayed intrathyroidal hematoma causing respiratory distress after a seemingly benign fall: a case report. Int J Emerg Med. 2010;3:431–3.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Saylam B, Comçali B, Ozer MV, et al. Thyroid gland haematoma after blunt neck trauma. West J Emerg Med. 2009;10:247–9.

    PubMed Central  PubMed  Google Scholar 

  6. Hagiwara A, Murata A, Matsuda T, et al. Thyroid storm after blunt thyroid injury: a case report. J Trauma. 2007;63:85–7.

    Article  Google Scholar 

  7. Rupprecht H, Rümenapf G, Braig H, et al. Acute bleeding caused by rupture of the thyroid gland following blunt neck trauma: case report. J Trauma. 1994;36:408–9.

    Article  CAS  PubMed  Google Scholar 

  8. Behrends RL, Low RB. Acute goiter hematoma following blunt neck trauma. Ann Emerg Med. 1987;16:1300–1.

    Article  CAS  PubMed  Google Scholar 

  9. Donatini G. Persistent dyspnea following thyroid hematoma after neck blunt trauma. Updates Surg. 2012;64:69–71.

    Article  PubMed  Google Scholar 

  10. Oka Y, Nishijima J, Azuma T, et al. Blunt thyroid trauma with acute hemorrhage and respiratory distress. J Emerg Med. 2007;32:381–5.

    Article  PubMed  Google Scholar 

  11. Vora NM, Fedok F, Stack BC Jr. Report of a rare case of trauma-induced thyroid storm. Ear Nose Throat J. 2002;81:570–4.

    PubMed  Google Scholar 

  12. Hsieh KC, Chou FF, Lee CH. Nonsurgical treatment of thyroid injury after blunt cervical trauma. Am J Emerg Med. 2000;18:739–41.

    Article  CAS  PubMed  Google Scholar 

  13. Blaivas M, Hom DB, Younger JG. Thyroid gland hematoma after blunt cervical trauma. Am J Emerg Med. 1999;17:348–50.

    Article  CAS  PubMed  Google Scholar 

  14. Pérez Fontán FJ, Santos Hernández M, Pombo Vázquez S, et al. Thyroid gland rupture after blunt neck trauma: sonographic and computed tomographic findings. J Ultrasound Med. 2001;20:1249–51.

    PubMed  Google Scholar 

  15. Stunell H, O’Brien J, Benfayed W, et al. Thyroid gland rupture after blunt cervical trauma. J Ultrasound Med. 2007;26:992.

    PubMed  Google Scholar 

  16. Zawawi F, Varshney R, Payne RJ, et al. Thyroid gland rupture: a rare finding after a blunt neck trauma. Int J Pediatr Otorhinolaryngol. 2013;77:863–5.

    Article  PubMed  Google Scholar 

  17. Sow YL, Aziz NA, Ng KL. Thyroid rupture secondary to blunt neck trauma. Am J Emerg Med. 2013;31:760. doi:10.1016/j.ajem.2012.12.005.

    Article  PubMed  Google Scholar 

  18. Hamid CH, Holland AJ, Cummins G, et al. Thyroid transection with spinal injury following blunt trauma in a child. Injury. 2004;35:332–5.

    Article  CAS  PubMed  Google Scholar 

  19. Pop D, Venissac N, Leo F, et al. Traumatic rupture of retrosternal goiter: a rare case of acute superior mediastinal syndrome. J Thorac Cardiovasc Surg. 2005;129:460–1.

    Article  PubMed  Google Scholar 

  20. Watson AP. Traumatic rupture of the thyroid gland. Australas Radiol. 1999;43:363–4.

    Article  CAS  PubMed  Google Scholar 

  21. Rivera-Serrano CM, Park BJ, Ferris RL. Traumatic thyroid hematoma associated with thyroid carcinoma. Ear Nose Throat J. 2012;91:25–6.

    Google Scholar 

  22. Weeks C, Moore FD Jr, Ferzoco SJ, et al. Blunt trauma to the thyroid: a case report. Am Surg. 2005;71:518–21.

    PubMed  Google Scholar 

  23. Hirshoren N, Hocwald E, Eliashar R. Isolated traumatic thyroid hemorrhage secondary to air bag deployment. Otolaryngol Head Neck Surg. 2004;130:791–3.

    Article  PubMed  Google Scholar 

  24. Lawton G. Traumatic haemorrhage into the thyroid simulating major vessel damage from deceleration injury. Thorax. 1974;29:607–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  25. Grace RH, Shilling JS. Acute haemorrhage into the thyroid gland following trauma and causing respiratory distress. Br J Surg. 1969;56:635–7.

    Article  CAS  PubMed  Google Scholar 

  26. Oertli D, Harder F. Complete traumatic transection of the thyroid gland. Surgery. 1994;115:527–9.

    CAS  PubMed  Google Scholar 

  27. Armstrong WB, Funk GF, Rice DH. Acute airway compromise secondary to traumatic thyroid hemorrhage. Arch Otolaryngol Head Neck Surg. 1994;120:427–30.

    Article  CAS  PubMed  Google Scholar 

  28. Rayn WJ. Hemorrhage into the thyroid gland resulting from a muscular effort: report of a case. Ann Surg. 1942;115:469–71.

    Article  Google Scholar 

  29. Jacobs RR. Acute hyperthyroidism precipitated by trauma. South Med J. 1979;72:890–1.

    Article  CAS  PubMed  Google Scholar 

  30. Lodder J. Traumatic rupture of the thyroid gland–a case report. S Afr J Surg. 2001;39:53–4.

    CAS  PubMed  Google Scholar 

  31. Bishop HM, Durman DC. Traumatic rupture of the thyroid gland. Am J Surg. 1948;75:524.

    Article  CAS  PubMed  Google Scholar 

  32. Seif FJ. Traumatic thyroid disease. Dtsch Med Wochenschr. 1990;115:1163.

    CAS  PubMed  Google Scholar 

  33. Baratto D. Isolated traumatic rupture of the thyroid. Friuli Med. 1953;8:73–6. (nicht auffindbar).

    CAS  PubMed  Google Scholar 

  34. Simon P Sur un cas de mort rapide, consécutive à une hémorrhagie primitive du corps thyroide. Rev méd de l’est (Nancy). 1894;26:77–81. (nicht auffindbar)

    Google Scholar 

  35. Delikoukos S, Mantzos F. Thyroid storm induced by blunt thyroid gland trauma. Am Surg. 2007;73:1247–9.

    PubMed  Google Scholar 

  36. Schimmack S, Schmitz-Winnenthal H, Bergmann F, et al. Rupture without warning. Lancet. 2011;377:966.

    Article  PubMed  Google Scholar 

  37. Shakespeare WA, Lanier WL, Perkins WJ, et al. Airway management in patients who develop neck hematomas after carotid endarterectomy. Anesth Analg. 2010;110:588–93.

    Article  PubMed  Google Scholar 

  38. Palumbo MA, Aidlen JP, Daniels AH, et al. Airway compromise due to wound hematoma following anterior cervical spine surgery. Open Orthop J. 2012;6:108–13.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Donatini G, Masoni T, Ricci V, et al. Acute respiratory distress following fine needle aspiration of thyroid nodule: case report and review of the literature. G Chir. 2010;31:387–9.

    CAS  PubMed  Google Scholar 

  40. Keogh IJ, Rowley H, Russell J. Critical airway compromise caused by neck haematoma. Clin Otolaryngol Allied Sci. 2002;27:244–5.

    Article  CAS  PubMed  Google Scholar 

  41. Wade JS. Cecil Joll Lecture, 1979. Respiratory obstruction in thyroid surgery. Ann R Coll Surg Engl. 1980;62:15–24.

    CAS  PubMed Central  PubMed  Google Scholar 

  42. Carr ER, Benjamin E. In vitro study investigating post neck surgery haematoma airway obstruction. J Laryngol Otol. 2009;123:662–5.

    Article  CAS  PubMed  Google Scholar 

  43. Thakur NA, McDonnell M, Paller D, et al. Wound hematoma after anterior cervical spine surgery: in vitro study of the pathophysiology of airway obstruction. Am J Orthop. 2013;42:35–7.

    Google Scholar 

  44. Moore EE, Cogbill TH, Jurkovich GJ, et al. Organ injury scaling: spleen and liver (1994 revision). J Trauma. 1995;38:323–4.

    Article  CAS  PubMed  Google Scholar 

  45. Cobzeanu MD, Palade D, Manea C Epidemiological features and management of complex neck trauma from an ENT surgeon’s perspective. Chirurgia (Bucur). 2013;108:360–4.

    CAS  Google Scholar 

  46. Karger S, Führer D. Thyroid storm–thyrotoxic crisis: an update. Dtsch Med Wochenschr. 2008;133:479–84.

    Article  CAS  PubMed  Google Scholar 

  47. Gregg-Smith SJ. Thyroid storm following chest trauma. Injury. 1993;24:422–3.

    Article  CAS  PubMed  Google Scholar 

  48. Burch HB, Wartofsky L. Life-threatening thyrotoxicosis. Thyroid storm. Endocrinol Metab Clin North Am. 1993;22:263–77.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Abteilung für Visceral- und Gefäßchirurgie, Krankenhaus Agatharied, 83734, Hausham, Deutschland

    Thomas von Ahnen,  Martin von Ahnen, Ulrich Wirth, Sven Zhorzel, Christopher Habbel,  Hans Martin Schardey &  Stefan Schopf

  2. Radiologie Oberland, 83734, Hausham, Deutschland

    Eveliina Kober

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  1. Thomas von Ahnen
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  2. Martin von Ahnen
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  3. Ulrich Wirth
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  4. Sven Zhorzel
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  7. Hans Martin Schardey
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  8. Stefan Schopf
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Correspondence to Thomas von Ahnen.

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Ahnen, T., Ahnen, M., Wirth, U. et al. Traumatische Schilddrüsenruptur: Fallbericht und Literaturübersicht. Wien Med Wochenschr 164, 239–244 (2014). https://doi.org/10.1007/s10354-014-0281-1

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