An atypical case of retropharyngeal abscess with long blind tract treated with Ryle's tube drainage
Tang, M.L.; Lee, S.C.; Phoon, M.P.Y.
Medical Journal of Malaysia 66(5): 501-503
2011
ISSN/ISBN: 0300-5283 PMID: 22390112 Document Number: 653338
A 10 year-old Iban girl presented with severe odynophagia for 4 days and subcutaneous emphysema. Clinically, her neck was tender with crepitus. Lateral neck radiograph showed multiple linear radiolucent shadows at retropharyngeal space. Flexible nasopharyngolaryngoscope revealed a tunnel behind upper oesophagus with slough and there was pooling of saliva at pyriform sinus. Feeding via nasogastric tube was started and empirical treatment for fungal and bacterial infection was commenced. Subsequent computed tomography of neck and thorax showed a 15-long blind tract at subglottic region posterior to oesophagus (prevertebral region), extending to superior mediastinum just before carina at T3/T4 level, represent abscess. Hourly suctioning of the remaining abscess in the blind tract with 10ml-syringe was done.