Abstract
BACKGROUND: Spontaneous Retropharyngeal Hematoma and cervical hematoma are rare conditions characterized by the accumulation of blood in the retropharyngeal and cervical region and poses a potential life-threatening risk. This complication can occur unexpectedly and without apparent trauma, particularly in patients on vitamin K antagonists. CASE PRESENTATION: A 60-year-old man presented to the emergency with acute dysphagia, dysphonia and a right-sided neck ecchymosis. The patient had been on vitamin K antagonists for 7 years following a left intraventricular thrombus. Blood tests revealed an International Normalized Ratio of 7. The diagnosis of Spontaneous Retropharyngeal Hematoma was suspected given the absence of an identified cause and was confirmed by contrast-enhanced computed tomography. The hematoma was attributed to the patient's long-term use of vitamin K antagonists, which predisposed him to spontaneous bleeding. Treatment involved the administration of vitamin K but the patient ultimately passed as a result of respiratory arrest. CONCLUSION: Spontaneous Retropharyngeal Hematoma due to VKA-related incidents is a rare but significant complication to consider in patients undergoing anticoagulant therapy. Awareness among healthcare professionals is crucial to ensure early recognition and appropriate management.