Shiny Overlying Skin in Surgery — 45yo Woman | General Surgery | SMLE Q#6140
SMLE Question #6140
Surgery
General Surgery
Objective: OBJ-TRACH-EMERG-01
Last updated: February 2026
A 45-year-old woman is 24 hours after a total thyroidectomy for multinodular goiter. She suddenly develops progressive neck tightness and difficulty breathing while speaking. Examination shows a tense, rapidly enlarging anterior neck swelling at the incision with shiny overlying skin; she is sitting upright and using accessory muscles. Imaging is not immediately available. What is the most appropriate next step in management?
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