Spontaneous haematoma of the pinna

A 5-week-old boy was seen with a 4 hour history of a spontaneous haematoma of the left ear pinna without a preceding history of trauma (fig 1). Aspiration of 0.5 mL of serosanguinous fluid coupled with a compression dressing was effective in managing the haematoma, and no cosmetic deformity resulted. Prompt treatment of such haematomas is advised to prevent deformity of the pinna. All haematological and clotting serological investigations did not find any abnormality. Figure 1 Photograph of left spontaneous pinna haematoma. The patient was born by an uncomplicated vaginal delivery at term gestation and no haematoma was identified until 5 weeks later, excluding a traumatic aetiology from birth. Although spontaneous haematoma of the ear is extremely rare and a review of the literature has not identified any published case reports, it is imperative to consider non-accidental injury as a potential causative factor. In this particular case all relevant guidelines and protocols were followed and subsequent investigations were completed but were unable to demonstrate co-existence of non-accidental injury.