Post-thyroidectomy haematoma

From Ganfyd

Rare, but potentially lethal complication of thyroid surgery. A degree of subcutaneous haematoma may be of little consequence, but on-going bleeding from the thyroid 'bed' can cause extrinsic compression of the trachea with consequent airway compromise and, if untreated, respiratory arrest. An alternative explanation for airway compromise is laryngeal and pharyngeal oedema resulting from venous and lymphatic obstruction (as the cartilaginous rings of the trachea tend to resist compression).

Emergency treatment involves removal of the skin clips or sutures and evacuation of the haematoma to reduce pressure.

Hospital areas which carry out thyroid surgery often have a thyroid pack which includes a stitch remover, stitch cutter and equipment for securing an airway. If airway compromise is severe, the airway should be secured by formal endotracheal intubation, or in cases of difficult intubation via tracheostomy.