Thyroid gland rupture after blunt neck trauma: A case report and review of the literature.

INTRODUCTION: Soft tissue injuries are relatively common after blunt neck trauma, because of its complex anatomy, many vital structures can be compromised. Isolated trauma to the thyroid is highly uncommon and there are few cases reported in the literature.

PRESENTATION OF CASE: A 19 year-old female patient with no known pathologies who sustained direct blunt trauma to the right frontal half of the neck after falling down from a stair case. She arrived at the ER with moderate neck swelling and pain. There were no visible hematomas and no respiratory compromise was noted. Contrast enhanced CT-scan showed rupture and hematoma of the right thyroid lobe; she underwent surgical exploration with hemi thyroidectomy and recovered uneventfully.

DISCUSSION: Despite soft tissue injuries are relatively common after blunt neck trauma, isolated thyroid gland injury is extremely rare and is present in about 1-2% of the cases and in most of the cases there is an underlining pathology within the gland. Most patients arrived at the emergency room hemodynamically stable, presenting neck swelling, pain, respiratory distress, dysphagia and hoarseness. Diagnosis strategy should be focused to rule out respiratory or vascular compromise. Surgical exploration remains the most common treatment strategy.

CONCLUSIONS: Although the rarity of this condition, physicians should take in mind the possibility of thyroid injury after blunt neck trauma. Early detection and prompt treatment, can reduce life threatening complications. Management should be individualized to patient's characteristics and surgeon's experience.