Forensic evaluation of fatal-suffocating retropharyngeal haematoma secondary to cervical fractures: Report of two cases

Abstract

Purpose: Traumatic retropharyngeal haematoma, a condition of low incidence, often occurs secondary to cervical injuries. Owing to the adjacent anatomical location and its insidious formation, retropharyngeal haematoma is prone to cause airway obstruction, which can occasionally be fatal. Though well known in clinical practice, retropharyngeal haematomas are rarely encountered in forensic practice and are not sufficiently explored from a forensic perspective.

Case presentation: Herein, we present two cases of fatal-suffocating retropharyngeal haematoma following cervical vertebral fractures. In both cases, the time from injury to death was evident, showing unusually long periods from injury to death, specifically 4 days and 2 days, respectively. The causes of death were illustrated, and the delayed onset of fatal airway obstruction was explained. The important points regarding autopsies suspected to be fatal traumatic retropharyngeal haematomas were discussed.

Conclusions: Knowledge of the possibility of late onset and understanding of the features of imaging and autopsy findings of traumatic retropharyngeal haematoma is beneficial for forensic pathologists dealing with similar cases.

Keywords: Airway obstruction; Cervical fracture; Forensic autopsy; Postmortem computed tomography; Retropharyngeal haematoma.