Retropharyngeal Abscess

Retropharyngeal abscess

Retropharyngeal abscess is formed as a result of suppuration of the lymph nodes and tissue of the retropharyngeal space. Infectious agents penetrate through the lymphatic tract from the nasal cavity, nasopharynx, auditory tube and middle ear. Sometimes an abscess is a complication of influenza, measles, scarlet fever, and can also develop when the mucous membrane of the posterior pharyngeal wall is injured by a foreign body or solid food.

It is usually observed in early childhood in malnourished and weakened children.

Symptoms, course: Complaints of choking and sharp pain when swallowing are typical, with food often getting into the nose. The patient refuses food. When the abscess is located in the nasopharynx, nasal breathing is disrupted and a closed nasal sound appears. When the abscess spreads to the lower parts of the pharynx, inspiratory shortness of breath occurs, accompanied by wheezing, especially when the patient is in an upright position. Body temperature reaches 39-40°C. The forced position of the head is characteristic: it is thrown back and tilted to the painful side. Swelling is often observed behind the angle of the lower jaw and along the anterior edge of the sternocleidomastoid muscle.

The diagnosis is confirmed by pharyngoscopy, which reveals a fluctuating swelling on the posterior wall of the pharynx. In the first days of the disease, a spherical protrusion of the posterior wall of the pharynx is located on one side, and later - along the midline. In doubtful cases, a diagnostic puncture is performed.

Complications: Acute swelling of the entrance to the larynx or spontaneous opening with suffocation due to pus entering the laryngeal cavity; pus may spread to the area of ​​the large vessels of the neck or descend along the prevertebral fascia into the chest cavity and cause purulent mediastinitis or compression of the trachea.

Treatment: Early opening of the retropharyngeal abscess followed by antibacterial and detoxification therapy.