unique MVC injury

[Guest guest]

First thank you to everyone for the advice on the last MVC pt w/ PSTD, she is

doing much better.

(All quotes are in the patient words.)

I have another pt who was in a MVC on 7/1/08 with a complaint that I have never

seen. A 40 yr old male, good height to weight, was stopped and " re-ended at

about 60MPH. The other car never even tried to brake, because she was texting.

My car is a pile of crumpled metal, my seat bakes even broke backwards. "

He went via ambulance to the ER: CT, plain films were normal, at that time his

complaints were moderate-severe back and neck pain, HA, and dizziness. Then 12

days later while sitting at home he felt his " throat start to close up like in

an allergic reaction, only I'm not allergic to anything " . His wife rushed him

to ER where the docs " said I have a boil and stuck it with a needle then I

gagged and coughed up globs of clotted bloody crap. " " Was that boil due to the

accident? "

I have only spoken to him at the time he made his appointment, he is due for

first exam/treatment on Monday. Therefore, I have do not have a more detailed

history or any exam finding to give you. But my initial instinct says; trauma

to the esophagus/oral pharynx which formed a hematoma. As the hematoma slowly

grew over 12 days it started to occlude the esophagus/oral pharynx and the ER

docs used the common term " boil " instead of explaining this to him.

He still is having moderate-severe neck and back pain with HA. At this time I am

planning activator treatments, to avoid any Cx rotation that might re-damage any

tissue.

Has anyone else seen this? If so is it crash related? Even though the ER docs

did not refer him should I consider a oral surgical referral? Any thoughts would

be great.

Thanks in advance.

Glenn Sykes, DC

Newberg Oregon

503-538-5433