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The 'sentinel clot' sign in spontaneous retropharyngeal hematoma secondary to parathyroid apoplexy

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September 1, 2006
by George Koulouris, FRANZCR; Marcus Pianta, MBBS; Stephen Stuckey, FRANZCR
Spontaneous retropharyngeal hemorrhage from a cervical parathyroid adenoma is a rare complication of primary hyperparathyroidism. Because of its rarity, it has seldom been documented in the radiologic or ENT literature. Patients may present with a variety of manifestations, ranging from dysphagia to dysphonia to life-threatening dyspnea or hemorrhage. Awareness of a possible thyroid or parathyroid etiology may expedite treatment and prevent unnecessary interventions. We present a case of spontaneous retropharyngeal hemorrhage in which the "sentinel clot" sign enabled us to identify the lesion of origin.

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