Atypical locations of retropharyngeal abscess: beware of the normal lateral soft tissue neck X-ray.

Hdl Handle:
http://hdl.handle.net/10147/207411
Title:
Atypical locations of retropharyngeal abscess: beware of the normal lateral soft tissue neck X-ray.
Authors:
Uzomefuna, Vincent; Glynn, Fergal; Mackle, Tara; Russell, John
Affiliation:
Otolaryngology Dept., Our Ladys Children Hospital Crumlin, Dublin 12, Ireland., uzomefuna@live.ie
Citation:
Int J Pediatr Otorhinolaryngol. 2010 Dec;74(12):1445-8. Epub 2010 Oct 15.
Journal:
International journal of pediatric otorhinolaryngology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207411
DOI:
10.1016/j.ijporl.2010.09.008
PubMed ID:
20951442
Abstract:
Retropharyngeal abscesses (RPA) are uncommon but potentially lethal deep neck space infections, over 95% of which occur in children under six years of age. Without a high index of suspicion, early recognition and prompt intervention, catastrophic consequences can ensue, and mortality can be as high as 60% if jugular vein thrombosis or mediastinitis occurs. While older children may have specific complaints referable to the pharynx, infants and young children may present with vague symptoms. To date, a lot of emphasis continues to be placed on the importance of lateral soft tissue neck X-ray in the diagnosis and management of patients with suspected retropharyngeal abscesses; and lateral neck X-ray has been cited as the most useful radiological view of the laryngopharynx. While we recognise the role of lateral neck X-rays in retropharyngeal and other upper airway pathologies, we present three case series in which lateral neck X-rays were normal and diagnosis was made only after CT scanning. These three cases were unusual as the abscesses were located high in the naso-pharynx making them impossible to detect on the lateral soft tissue neck X-rays and this underscores the need for high index of suspicion and prompt CT or MRI scanning, in any child with symptoms or signs suggestive of a possible retropharyngeal abscess.
Language:
eng
MeSH:
Child, Preschool; Diagnosis, Differential; Humans; Male; *Neck/radiography; Retropharyngeal Abscess/diagnosis/*radiography; *Tomography, X-Ray Computed
ISSN:
1872-8464 (Electronic); 0165-5876 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorUzomefuna, Vincenten_GB
dc.contributor.authorGlynn, Fergalen_GB
dc.contributor.authorMackle, Taraen_GB
dc.contributor.authorRussell, Johnen_GB
dc.date.accessioned2012-02-01T10:24:19Z-
dc.date.available2012-02-01T10:24:19Z-
dc.date.issued2012-02-01T10:24:19Z-
dc.identifier.citationInt J Pediatr Otorhinolaryngol. 2010 Dec;74(12):1445-8. Epub 2010 Oct 15.en_GB
dc.identifier.issn1872-8464 (Electronic)en_GB
dc.identifier.issn0165-5876 (Linking)en_GB
dc.identifier.pmid20951442en_GB
dc.identifier.doi10.1016/j.ijporl.2010.09.008en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207411-
dc.description.abstractRetropharyngeal abscesses (RPA) are uncommon but potentially lethal deep neck space infections, over 95% of which occur in children under six years of age. Without a high index of suspicion, early recognition and prompt intervention, catastrophic consequences can ensue, and mortality can be as high as 60% if jugular vein thrombosis or mediastinitis occurs. While older children may have specific complaints referable to the pharynx, infants and young children may present with vague symptoms. To date, a lot of emphasis continues to be placed on the importance of lateral soft tissue neck X-ray in the diagnosis and management of patients with suspected retropharyngeal abscesses; and lateral neck X-ray has been cited as the most useful radiological view of the laryngopharynx. While we recognise the role of lateral neck X-rays in retropharyngeal and other upper airway pathologies, we present three case series in which lateral neck X-rays were normal and diagnosis was made only after CT scanning. These three cases were unusual as the abscesses were located high in the naso-pharynx making them impossible to detect on the lateral soft tissue neck X-rays and this underscores the need for high index of suspicion and prompt CT or MRI scanning, in any child with symptoms or signs suggestive of a possible retropharyngeal abscess.en_GB
dc.language.isoengen_GB
dc.subject.meshChild, Preschoolen_GB
dc.subject.meshDiagnosis, Differentialen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.mesh*Neck/radiographyen_GB
dc.subject.meshRetropharyngeal Abscess/diagnosis/*radiographyen_GB
dc.subject.mesh*Tomography, X-Ray Computeden_GB
dc.titleAtypical locations of retropharyngeal abscess: beware of the normal lateral soft tissue neck X-ray.en_GB
dc.contributor.departmentOtolaryngology Dept., Our Ladys Children Hospital Crumlin, Dublin 12, Ireland., uzomefuna@live.ieen_GB
dc.identifier.journalInternational journal of pediatric otorhinolaryngologyen_GB
dc.description.provinceLeinster-

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