Retropharyngeal abscess - Revision history

Rossdonaldson1 at 21:56, 13 November 2024

2024-11-13T21:56:30Z

← Older revision		Revision as of 21:56, 13 November 2024
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	==Background==		==Background==
			[[File:Gray1014.png\|thumb\|Anatomy of the posterior pharynx.]]
	[[File:Infrahyoid deep neck spaces.png\|thumb\|Infrahyoid deep neck spaces]]		[[File:Infrahyoid deep neck spaces.png\|thumb\|Infrahyoid deep neck spaces]]
	[[File:EB1911 - Tongue.png\|thumb\|Neck anatomy at the level of the tongue.]]		[[File:EB1911 - Tongue.png\|thumb\|Neck anatomy at the level of the tongue.]]

Rossdonaldson1 at 21:56, 13 November 2024

2024-11-13T21:56:06Z

← Older revision		Revision as of 21:56, 13 November 2024
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	==Background==		==Background==
			[[File:Infrahyoid deep neck spaces.png\|thumb\|Infrahyoid deep neck spaces]]
			[[File:EB1911 - Tongue.png\|thumb\|Neck anatomy at the level of the tongue.]]
			[[File:Human anatomy, including structure and development and practical considerations (1911) (14594049867).jpg\|thumb\|Midline neck anatomy on lateral view.]]

	*Polymicrobial [[abscess]] in space between posterior pharyngeal wall and prevertebral fascia		*Polymicrobial [[abscess]] in space between posterior pharyngeal wall and prevertebral fascia
	*Adults: Due to direct extension of purulent debris from adjacent site (e.g. [[Ludwig's angina]])		*Adults: Due to direct extension of purulent debris from adjacent site (e.g. [[Ludwig's angina]])

Rossdonaldson1: /* Evaluation */

2022-01-06T05:22:25Z

Evaluation

← Older revision		Revision as of 05:22, 6 January 2022
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	[[File:RPA CT.png\|thumb\|Retropharyngeal abscess on CT]]		[[File:RPA CT.png\|thumb\|Retropharyngeal abscess on CT]]
	[[File:LargeRetroAbsMark.png\|thumb\|Large retropharyngeal abscess as seen on CT.]]		[[File:LargeRetroAbsMark.png\|thumb\|Large retropharyngeal abscess as seen on CT.]]
			[[File:PMC3201680 TSWJ11-915163.004.png\|thumb\|CT (transversal view) showing retropharyngeal abscess collection.]]
	*CT neck with IV contrast		*CT neck with IV contrast
	**Gold standard		**Gold standard

Rossdonaldson1: /* Clinical Features */

2022-01-06T05:18:16Z

Clinical Features

← Older revision		Revision as of 05:18, 6 January 2022
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	==Clinical Features==		==Clinical Features==
			[[File:PMC3201680 TSWJ11-915163.001.png\|thumb\|Bulging of the posterior wall of the oropharynx due to retropharyngeal abscess.]]
	===Initial symptoms===		===Initial symptoms===
	*[[Sore throat]] (76%)		*[[Sore throat]] (76%)

Rossdonaldson1: /* Evaluation */

2021-03-18T15:53:53Z

Evaluation

← Older revision		Revision as of 15:53, 18 March 2021
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	[[File:RPA xray.JPG\|thumb\|A lateral x-ray demonstrating prevertebral soft tissue swelling (marked by the arrow) ]]		[[File:RPA xray.JPG\|thumb\|A lateral x-ray demonstrating prevertebral soft tissue swelling (marked by the arrow) ]]
	[[File:RPA CT.png\|thumb\|Retropharyngeal abscess on CT]]		[[File:RPA CT.png\|thumb\|Retropharyngeal abscess on CT]]
			[[File:LargeRetroAbsMark.png\|thumb\|Large retropharyngeal abscess as seen on CT.]]
	*CT neck with IV contrast		*CT neck with IV contrast
	**Gold standard		**Gold standard

	*XR Soft tissue		===XR Soft tissue===
	**Neck in extension at end inspiration		*Neck in extension at end inspiration
	**The prevertebral space should be less than 7mm at C2, 14mm at C6 in children regardless of the age		*The prevertebral space should be less than 7mm at C2, 14mm at C6 in children regardless of the age
	**The prevertebral space should be less than 22mm at C6 in adults		*The prevertebral space should be less than 22mm at C6 in adults
	**The prevertebral space should be less than one-half the width of the corresponding vertebral body		*The prevertebral space should be less than one-half the width of the corresponding vertebral body
	**If equivocal XR, order CT		*If equivocal XR, order CT

	==Management==		==Management==

Rossdonaldson1 at 15:51, 18 March 2021

2021-03-18T15:51:05Z

← Older revision		Revision as of 15:51, 18 March 2021
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	*[[Trauma]]: Direct inoculation (e.g. child falling with stick in mouth)		*[[Trauma]]: Direct inoculation (e.g. child falling with stick in mouth)
	*Patients may prefer to lay supine to prevent abscess and edematous posterior wall to collapse into airway, so patients should not be forced to sit up		*Patients may prefer to lay supine to prevent abscess and edematous posterior wall to collapse into airway, so patients should not be forced to sit up
	~~[[File:RPA CT.png\|thumb\|Retropharyngeal abscess on CT]]~~

	==Clinical Features==		==Clinical Features==
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	==Evaluation==		==Evaluation==
	[[File:RPA xray.JPG\|thumb\|A lateral x-ray demonstrating prevertebral soft tissue swelling (marked by the arrow) ]]		[[File:RPA xray.JPG\|thumb\|A lateral x-ray demonstrating prevertebral soft tissue swelling (marked by the arrow) ]]
			[[File:RPA CT.png\|thumb\|Retropharyngeal abscess on CT]]
	*CT neck with IV contrast		*CT neck with IV contrast
	**Gold standard		**Gold standard

ClaireLewis at 22:34, 30 September 2019

2019-09-30T22:34:56Z

← Older revision		Revision as of 22:34, 30 September 2019
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	==Background==		==Background==
	*Polymicrobial [[abscess]] in space between posterior pharyngeal wall and prevertebral fascia		*Polymicrobial [[abscess]] in space between posterior pharyngeal wall and prevertebral fascia
	*Adults: Due to direct extension of purulent debris from adjacent site (e.g. Ludwig angina)		*Adults: Due to direct extension of purulent debris from adjacent site (e.g. [[Ludwig's angina]])
	**More likely to extend into the mediastinum		**More likely to extend into the mediastinum
	*Children: Due to suppurative changes within a lymph node (primary infection elsewhere in head or neck)		*Children: Due to suppurative changes within a lymph node (primary infection elsewhere in head or neck)
	*Trauma: Direct inoculation (e.g. child falling with stick in mouth)		*[[Trauma]]: Direct inoculation (e.g. child falling with stick in mouth)
	*Patients may prefer to lay supine to prevent abscess and edematous posterior wall to collapse into airway, so patients should not be forced to sit up		*Patients may prefer to lay supine to prevent abscess and edematous posterior wall to collapse into airway, so patients should not be forced to sit up
	[[File:RPA CT.png\|thumb\|Retropharyngeal abscess on CT]]		[[File:RPA CT.png\|thumb\|Retropharyngeal abscess on CT]]
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	==Clinical Features==		==Clinical Features==
	===Initial symptoms===		===Initial symptoms===
	*Sore throat (76%)		*[[Sore throat]] (76%)
	*Fever (65%)		*[[Fever]] (65%)
	*[[Torticollis]] (37%)		*[[Torticollis]] (37%)
	*[[Dysphagia]] (35%)		*[[Dysphagia]] (35%)
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	===Complications===		===Complications===
	*Mediastinitis, sepsis, aspiration from spontaneous abscess formation		*[[Mediastinitis]], [[sepsis]], [[aspiration pneumonia and pneumonitis\|aspiration]] from spontaneous abscess formation
	*Jugular venous thrombosis, Lemierre's syndrome		*Jugular venous thrombosis, [[Lemierre's syndrome]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Management==		==Management==
	#Emergent ENT consult		#Emergent ENT consult
	#*Most patients require I&D		#*Most patients require [[I&D]]
	#*Indications for drainage - trismus, rim enhancement on CT		#*Indications for drainage - trismus, rim enhancement on CT
	#Secure airway - care must be taken to minimize contact with [[abscess]] as rupture is significant risk		#Secure airway - care must be taken to minimize contact with [[abscess]] as rupture is significant risk
	##Tracheostomy or fiberoptic intubation may be necessary		##[[Tracheostomy]] or fiberoptic [[intubation]] may be necessary
	##CT or MRI may help prepare for method of definitive airway<ref>Mulimani SM. Anesthetic management of tuberculous retropharyngeal [[abscess]] in adult. J Anaesthesiol Clin Pharmacol. 2012 Jan-Mar; 28(1): 128–129.</ref>		##CT or MRI may help prepare for method of definitive airway<ref>Mulimani SM. Anesthetic management of tuberculous retropharyngeal [[abscess]] in adult. J Anaesthesiol Clin Pharmacol. 2012 Jan-Mar; 28(1): 128–129.</ref>

Gheid: /* Clinical Features */

2019-06-23T18:52:33Z

Clinical Features

← Older revision		Revision as of 18:52, 23 June 2019
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	*Drooling, neck stiffness		*Drooling, neck stiffness
	*Involvement of carotid neurovascular sheath		*Involvement of carotid neurovascular sheath

			===Complications===
			*Mediastinitis, sepsis, aspiration from spontaneous abscess formation
			*Jugular venous thrombosis, Lemierre's syndrome

	==Differential Diagnosis==		==Differential Diagnosis==

Gheid: /* Late symptoms */

2019-06-23T18:48:39Z

Late symptoms

← Older revision		Revision as of 18:48, 23 June 2019
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	===Late symptoms===		===Late symptoms===
	*[[Stridor]], [[respiratory distress]], [[chest pain]] ([[mediastinitis]])		*[[Stridor]], [[respiratory distress]], [[chest pain]] ([[mediastinitis]])
			*Drooling, neck stiffness
	*Involvement of carotid neurovascular sheath		*Involvement of carotid neurovascular sheath

Kxl328: /* Background */

2018-10-03T03:39:49Z

Background

← Older revision		Revision as of 03:39, 3 October 2018
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	*Children: Due to suppurative changes within a lymph node (primary infection elsewhere in head or neck)		*Children: Due to suppurative changes within a lymph node (primary infection elsewhere in head or neck)
	*Trauma: Direct inoculation (e.g. child falling with stick in mouth)		*Trauma: Direct inoculation (e.g. child falling with stick in mouth)
			*Patients may prefer to lay supine to prevent abscess and edematous posterior wall to collapse into airway, so patients should not be forced to sit up
	[[File:RPA CT.png\|thumb\|Retropharyngeal abscess on CT]]		[[File:RPA CT.png\|thumb\|Retropharyngeal abscess on CT]]