scholarly journals Acute Retropharyngeal Abscess Masquerading as Meningitis

2017 ◽  
Vol 56 (205) ◽  
pp. 186-188 ◽  
Author(s):  
Pirabu Sakthivel ◽  
Rijendra Yogal ◽  
Hitesh Verma ◽  
Anil Saini ◽  
Ashwin Chandran
Keyword(s):  
Airway Obstruction ◽  
High Index ◽  
Retropharyngeal Abscess ◽  
Deep Neck Infection ◽  
Imaging Studies ◽  
X Ray ◽  
Neck Infection ◽  
High Index Of Suspicion ◽  
Physical Findings ◽  
Prompt Diagnosis

Retropharyngeal abscess is a potentially serious deep neck space infection occurring more frequently in children than in adults. The clinical picture of RPA is highly variable with paucity of physical findings. Prompt diagnosis of RPA especially in infants is mandatory to prevent potential fatal complications including airway obstruction. The diagnosis of RPA should be based on high index of clinical suspicion with supportive imaging studies like lateral X-ray of neck and CT. We present a case of acute retropharyngeal abscess which was initially misdiagnosed as meningitis and led to airway obstruction. This case is reported to create awareness among emergency physicians, paediatricians and otolaryngologists to have high index of suspicion in diagnosing RPA especially in infants. Keywords:  retropharyngeal abscess; meningitis; deep neck infection.

A dangerous cause of airway obstruction: deep neck infection

2020 ◽  
Keyword(s):  
Airway Obstruction ◽  
Upper Airway ◽  
Deep Neck Infection ◽  
Jugular Vein Thrombosis ◽  
Neck Infection ◽  
Vein Thrombosis ◽  
Lethal Complications ◽  
Life Threatening ◽  
Fascial Spaces ◽  
Emergency Doctors

Deep neck infection (DNI) is an infection in the fascial spaces of the neck. Complications of DNI, including mediastinitis, internal jugular vein thrombosis, and upper airway obstruction, are severe and potentially life threatening. Therefore, early identification and accurate management of DNI are essential. We review the anatomy of the deep spaces of the neck to determine the route of DNI spread so that emergency doctors, physicians, and otorhinolaryngologists can quickly recognize the development of lethal complications of DNI, such as asphyxia from airway obstruction.

scholarly journals Diagnosing gastric volvulus in chest X-ray: report of three cases

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Narendra Pandit ◽  
Abhijeet Kumar ◽  
Tek Narayan Yadav ◽  
Qamar Alam Irfan ◽  
Sujan Gautam ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Abdomen ◽  
Gastric Volvulus ◽  
X Ray ◽  
Pain Abdomen ◽  
Life Threatening ◽  
Chest X Ray ◽  
High Index Of Suspicion ◽  
Specific Symptoms ◽  
Prompt Diagnosis

Abstract Gastric volvulus is a rare abnormal rotation of the stomach along its axis. It is a surgical emergency, hence requires prompt diagnosis and treatment to prevent life-threatening gangrenous changes. Hence, a high index of suspicion is required in any patients presenting with an acute abdomen in emergency. The entity can present acutely with pain abdomen and vomiting, or as chronic with non-specific symptoms. Chest X-ray findings to diagnose it may be overlooked in patients with acute abdomen. Here, we report three patients with gastric volvulus, where the diagnosis was based on the chest X-ray findings, confirmed with computed tomography, and managed successfully with surgery.

scholarly journals Factors Affecting Patients with Concurrent Deep Neck Infection and Acute Epiglottitis

Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 29
Author(s):  
Chia-Ying Ho ◽  
Yu-Chien Wang ◽  
Shy-Chyi Chin ◽  
Shih-Lung Chen
Keyword(s):  
Risk Factors ◽  
Airway Obstruction ◽  
Parapharyngeal Space ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Deep Neck Infection ◽  
Acute Epiglottitis ◽  
Neck Infection ◽  
Submandibular Space ◽  
Independent Risk Factors

Deep neck infection (DNI) is a serious disease of deep neck spaces that can lead to morbidities and mortality. Acute epiglottitis (AE) is a severe infection of the epiglottis, which can lead to airway obstruction. However, there have been no studies of risk factors in patients with concurrent DNI and AE. This study was performed to investigate this issue. A total of 502 subjects with DNI were enrolled in the study between June 2016 and August 2021. Among these patients, 30 had concurrent DNI and AE. The relevant clinical variables were assessed. In a univariate analysis, involvement of the parapharyngeal space (OR = 21.50, 95% CI: 2.905–158.7, p < 0.001) and involvement of the submandibular space (OR = 2.064, 95% CI: 0.961–4.434, p < 0.001) were significant risk factors for concurrent DNI and AE. In a multivariate analysis, involvement of the parapharyngeal space (OR = 23.69, 95% CI: 3.187–175.4, p = 0.002) and involvement of the submandibular space (OR = 2.465, 95% CI: 1.131–5.375, p < 0.023) were independent risk factors for patients with concurrent DNI and AE. There were no differences in pathogens, therapeutic managements (tracheostomy, intubation, surgical drainage), or hospital staying period between the 30 patients with concurrent DNI and AE and the 472 patients with DNI alone (all p > 0.05). However, we believe it is significant that DNI and AE are concurrent because both DNI and AE potentially cause airway obstruction, and concurrence of these two diseases make airway protection more difficult. The infections in critical spaces may cause the coincidence of these two diseases. Involvement of the parapharyngeal space and involvement of the submandibular space were independent risk factors associated with concurrent DNI and AE. There were no differences in pathogens between the concurrent DNI and AE group and the DNI alone group.

Upper airway obstruction

2020 ◽  
pp. 4040-4048
Author(s):  
James H. Hull ◽  
Matthew Hind
Keyword(s):  
Airway Obstruction ◽  
Tracheal Stenosis ◽  
Upper Airway ◽  
Normal Function ◽  
Forced Expiratory Volume ◽  
Upper Airway Obstruction ◽  
Smoke Inhalation ◽  
Medical Emergency ◽  
Retropharyngeal Abscess ◽  
High Index Of Suspicion

The upper airway is anatomically defined by the carina inferiorly and pharynx superiorly, with pathology predominately arising from the trachea and larynx. Obstruction of the upper airway may arise because of a fixed structural pathology such as tracheal stenosis or malignancy, but can arise following loss of normal function (e.g. inappropriate vocal cord adduction). A high index of suspicion is required to make the diagnosis because the clinical features of upper airway obstruction can mimic other respiratory conditions. Calculation of the ratio of forced expiratory volume in one second to peak expiratory flow (Empey index) may identify patients with unsuspected upper airway obstruction. Acute upper airway obstruction is a medical emergency and usually caused by aspiration, oedema (allergic, hereditary, and acquired angio-oedema, smoke inhalation), or infection (croup, epiglottitis, quinsy, retropharyngeal abscess). Non-acute causes of upper airway obstruction include malignancy, tracheal stenosis, tracheal compression, dynamic large airway collapse, and laryngeal dysfunction.

scholarly journals A Case of Retropharyngeal Abscess Resulting from Infected Paratracheal Cyst

2020 ◽  
Vol 63 (3) ◽  
pp. 134-137
Author(s):  
Eun Soo Lee ◽  
Heon Soo Park ◽  
Sang Hyeon Kim ◽  
Dong Kun Lee
Keyword(s):  
Chronic Infection ◽  
Total Population ◽  
Case Reports ◽  
Retropharyngeal Abscess ◽  
Deep Neck Infection ◽  
Ciliated Epithelium ◽  
Neck Infection ◽  
Common Location ◽  
Tracheal Diverticulum ◽  
The Right

A paratracheal cyst is an air-filled cyst lined by a ciliated epithelium, commonly referred to as a tracheal diverticulum. The most common location of paratracheal cysts is the right side of posterolateral tracheal wall. It occurs in 0.3% to 8.1% of the total population. Most paratracheal cysts are asymptomatic and discovered incidentally on routine radiologic examination. Rarely, however, symptoms such as cough or fever are encountered and chronic infection of the paratracheal cyst usually present itself like a tucoberculosis or a tumor. There are few case reports of deep neck infection caused by a paratracheal cyst. We report a case of retropharyngeal abscess resulting from an infected paratracheal cyst.

scholarly journals Foreign Body Ingestion: Rare Cause of Cervical Abscess

2014 ◽  
Vol 27 (6) ◽  
pp. 743 ◽  
Author(s):  
Liliana Costa ◽  
João Larangeiro ◽  
Carla Pinto Moura ◽  
Margarida Santos
Keyword(s):  
Foreign Body ◽  
Rare Complication ◽  
Flexible Endoscopy ◽  
Retropharyngeal Abscess ◽  
Foreign Body Ingestion ◽  
Deep Neck Infection ◽  
Diagnostic Challenge ◽  
Foreign Body Removal ◽  
Neck Infection ◽  
Rigid Esophagoscopy

<p><strong>Introduction:</strong> Foreign body ingestion is a frequent emergency occurrence. Serious complications, although rare, include pharyngooesophageal perforation, aorto-oesophageal fistula and deep neck infection.<br /><strong>Material and Methods:</strong> A retrospective review was performed of all cases of foreign body ingestion requiring hospitalization between 1989 and 2011, in a tertiary Hospital. Cases complicated by deep cervical abscess were selected and their clinical presentation, results of diagnostic exams, therapeutics and clinical evolution are presented.<br /><strong>Results: </strong>Among a total of 1679 cases, 319 were related to pediatric patients and 1360 to adults. Two cases were reported (0.12%): an adult, 41 years-old, with parapharyngeal abscess subsequent to fishbone ingestion, and a child, 13 months-old, with retropharyngeal abscess consequent to chicken bone ingestion. Complications appeared three and four days after foreign body removal, respectively. In both situations cervical computerized tomography scan with contrast and surgical drainage were accomplished; the child was also submitted to rigid esophagoscopy for residual foreign body removal and closure of the associated pharyngeal laceration.<br /><strong>Discussion:</strong> Deep cervical abscesses are an uncommon but possible complication of foreign body ingestion and constitute a diagnostic challenge, particularly in children. Previous oesophageal manipulation by flexible endoscopy may be considered a risk factor for such complication. Imagiological studies proved to be crucial for diagnosis and therapeutic planning.<br /><strong>Conclusion:</strong> Although a rare complication, given a recent history of foreign body ingestion/removal and the presence of compatible symptoms, cervical abscesses should be taken into account, highlighting their potential morbimortality in the absence of an appropriate therapeutic approach.<br /><strong>Keywords:</strong> Foreign Body; Abscess; Esophagoscopy; Neck.</p>

scholarly journals Occult Foreign Bodies in ENT

2015 ◽  
Vol 23 (2) ◽  
pp. 73-76
Author(s):  
Bijan Kumar Adhikary ◽  
Subhra Deb Biswas ◽  
Avick Das ◽  
Swapan Kumar Ghosh
Keyword(s):  
Foreign Body ◽  
Ct Scan ◽  
Foreign Bodies ◽  
High Index ◽  
X Ray ◽  
High Index Of Suspicion ◽  
Separate Incision

IntroductionForeign bodies are common ENT emergencies. Histories are usually forthcoming from the patient himself or the relatives . Three occult foreign bodies are reported here, which were missed even by treating doctors, with discussion about steps to avoid such errors in future. Case SeriesCase 1: Though the history was apparent, the foreign body was removed only after 13 years from the Zygomatic region.Case 2: The parents were aware of the foreign body but inadequate investigations led to a delayed diagnosis.Case 3: The history clinched the diagnosis. Pre operative localization and separate incision to remove the foreign body saved the vital structures. DiscussionA high index of suspicion, meticulous history and proper investigation like x-ray or CT scan or MRI of the diseased area may help in locating the hidden foreign bodies in the ENT region.

Stridor: an unusual presentation of lateral medullary syndrome

2007 ◽  
Vol 121 (7) ◽  
pp. 1-2 ◽  
Author(s):  
S Vaidyanathan ◽  
R Capper ◽  
D Chadha
Keyword(s):  
Airway Obstruction ◽  
Unusual Case ◽  
Upper Airway ◽  
High Index ◽  
Upper Airway Obstruction ◽  
Unusual Presentation ◽  
Angioneurotic Oedema ◽  
Lateral Medullary Syndrome ◽  
High Index Of Suspicion

We report an unusual case of lateral medullary syndrome which presented with symptoms of acute upper airway obstruction mimicking angioneurotic oedema. Although dysphonia and dysphagia are common symptoms of lateral medullary syndrome, we have found no other reports of this condition presenting as stridor. This case highlights the importance of maintaining a high index of suspicion for central causes of common otolaryngological symptoms in the absence of local signs.

scholarly journals Retropharyngeal abscess rare presentation in a 11 months old infant: a case report

2017 ◽  
Vol 3 (2) ◽  
pp. 443
Author(s):  
Roa T. Halawani ◽  
Bayan Aboshargyah
Keyword(s):  
Case Report ◽  
Young Children ◽  
Unusual Presentation ◽  
Retropharyngeal Abscess ◽  
Deep Neck Infection ◽  
Rare Presentation ◽  
Neck Infection

<p class="abstract">Retropharyngeal abscess (RPA) is a rare deep neck infection that usually affects young children. It is the most common deep neck infection in children. We would like to present this case because of unusual presentation at this age<span lang="EN-IN">.</span></p>

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