Laryngopharyngeal thermal injury from ingested food is uncommon in adults. When accompanied by laryngeal oedema, it can progress to life-threatening airway obstruction. We report a case of laryngopharyngeal thermal injury in an otherwise healthy man in his 20s after ingesting microwave-heated homemade chocolate. The chocolate was fed to the patient by another person using a spoon while his neck was extended. Although the surface appeared solid and cool, the interior had reached a high temperature. Unable to expectorate the bolus, the patient swallowed it, sustaining a direct thermal insult to the laryngopharynx without visible oral mucosal burns. Laryngoscopy the following day revealed marked erythema and oedema of the right arytenoid region and epiglottic laryngeal surface. He was treated with intravenous methylprednisolone and ampicillin/sulbactam and discharged on day 3. This case highlights that neck extension during feeding can allow hot material to pass through the oral cavity too rapidly to permit protective reflexes and directly injure the laryngopharynx, even with solid foods.

C2-C3 disc herniation is an extremely rare condition, accounting for <1% of all cervical disc herniations. Discectomy using the posterior transdural or anterior transretropharyngeal approach has been used for its treatment. However, there are still concerns regarding the invasiveness and potential complications of these techniques. Herein, we report a case of C2-C3 disc herniation treated with transvertebral discectomy, assisted by an intraoperative navigation system. An 80-year-old woman presented with worsening numbness and pain in the left upper extremity, as well as gait instability. Magnetic resonance imaging revealed a left-dominant C2-C3 disc herniation compressing the spinal cord. As symptoms showed minimal improvement with conservative treatment, surgical intervention was performed. Through a 4-cm transverse incision on the left side of the neck and a 6-mm bone window, a transvertebral discectomy was performed to remove the C2-C3 disc herniation. An intraoperative navigation system was used to enhance surgical accuracy. The herniated disc fragment was successfully removed via the transvertebral approach without intraoperative complications. Intraoperative navigation helped ensure a safe and accurate surgical procedure. The patient's symptoms improved immediately, and she was discharged to home 1 week later. Transvertebral discectomy enables minimally invasive removal of C2-C3 disc herniation. Combined preoperative magnetic resonance imaging and intraoperative computed tomography using navigation system supports a safer and more comprehensive removal.

Chondroid syringoma (CS) is a rare skin adnexal tumour originating from sweat glands, sharing histological features with pleomorphic adenomas of the salivary gland. The usual site is the head and neck, and it preponderates in middle age with a male predominance. Accounting for fewer than 0.1% of all cutaneous tumours, CS is an uncommon and typically benign lesion. Its slow growth and non-specific appearance often lead to confusion with more common entities like epidermoid cysts or lipoma. We present the case of a female in her mid-60s with a painless swelling on her right cheek, slowly growing for the last 2 years. From its appearance, consistency and location, a clinical diagnosis of calcified lipoma was made. Excision, however, revealed a firm solid tumour having a biphasic histology of islands of epithelial cells admixed with a chondromyxoid stroma with focal adipocytic metaplasia. The patient was discharged without event and is being followed-up.

Ludwig's angina and odontogenic deep neck space infections represent high-risk scenarios for anaesthesiologists, as airway compromise may develop despite initially preserved spontaneous breathing. We report a 41-year-old woman with no relevant comorbidities who presented with a five-day history of odontogenic right-sided neck swelling, fever, odynophagia, dysphagia, muffled voice, and mild discomfort in the supine position. She was breathing spontaneously on room air with an oxygen saturation of 98%. CT neck demonstrated a right submandibular collection measuring 3 × 0.6 cm, multiple right sternocleidomastoid (SCM) intramuscular collections, and bilateral deep cervical lymphadenopathy. Leftward tracheal deviation was identified on clinical imaging review. On Day 0, emergency drainage was performed under general anaesthesia. C-MAC video laryngoscopy revealed a Cormack-Lehane grade 1 view; the trachea was intubated on the first attempt with rocuronium 1.2 mg/kg, without complication. The patient was maintained intubated in the ICU for approximately 24 hours and extubated following cuff-leak testing, corticosteroid pre-treatment, and multidisciplinary team reassessment. On Day 5, a second general anaesthetic was required for repeat drainage; again, grade 1 direct laryngoscopy, first-attempt intubation, and immediate post-procedure extubation were achieved. The pus culture grew Streptococcus agalactiae, susceptible to levofloxacin, vancomycin, and amoxicillin/clavulanate. Total antimicrobial therapy comprised seven days of intravenous therapy followed by 14 days of oral amoxicillin/clavulanate, for a total course of 21 days. The patient was discharged on Day 13 in stable condition. This case highlights that the absence of stridor or hypoxaemia does not eliminate significant airway risk in deep neck infection. Muffled voice, pain-limited oral assessment, supine discomfort, multi-compartment collections, SCM involvement, and tracheal deviation require structured difficult-airway planning, surgical airway readiness, planned extubation, and repeat airway reassessment for subsequent procedures.

Spontaneous hemoperitoneum in the postpartum period is a rare and potentially life-threatening obstetric emergency that may present with sudden hemodynamic collapse. We report the case of a 30-year-old gravida 3, para 1, living 1, abortion 1 woman at 39 weeks of gestation with a previous lower-segment cesarean section who underwent a successful vaginal birth after cesarean (VBAC) of a healthy female neonate weighing 2.95 kg. One hour after delivery, despite stable vital signs and absence of vaginal bleeding, she developed sudden circulatory collapse with abdominal distension and hypovolemic shock. Laboratory investigations revealed severe anemia with hemoglobin of 6.7 g/dL, thrombocytopenia, and metabolic acidosis with elevated lactate levels. Bedside ultrasonography demonstrated significant intraperitoneal free fluid, and diagnostic tapping confirmed hemoperitoneum. Emergency exploratory laparotomy revealed approximately 3.8 liters of hemoperitoneum with clots. The uterus was exteriorized and systematically examined; the previous cesarean scar was intact, with no evidence of uterine rupture or dehiscence. The adnexa, broad ligaments, pelvic and retroperitoneal regions, and upper abdominal viscera were carefully examined, but no definite source of bleeding could be identified. Stepwise surgical devascularization with bilateral uterine artery ligation and descending cervical artery ligation was performed as an empirical hemorrhage-control measure. The patient received massive transfusion support, recovered satisfactorily in the intensive care unit, and was discharged in stable condition. This case highlights the importance of maintaining a high index of suspicion for spontaneous hemoperitoneum in postpartum women presenting with unexplained shock, even in the absence of vaginal bleeding.