Acute suppurative thyroiditis in children secondary to pyriform sinus fistula

Prasad, T. R. Sai; Chong, Chia Li; Mani, Arun Mathai; Chui, Chan Hon; Tan, Chek Tien; Tee, Wen Sim Nancy; Jacobsen, Anette Sundfor

doi:10.1007/s00383-007-1939-1

Cited by 33 publications

(23 citation statements)

References 13 publications

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“…These anomalies have multiple presentations, including thyroid abscesses, recurrent sinuses, neck cellulitis and compressive symptoms, including dysphagia and odynophagia. A pyriform sinus fistula often becomes symptomatic during childhood and adolescent years, and thus it is important to consider this anomaly in a young patient with such a presentation (Sai Prasad et al, 2007). Other causes of AST and an abscess of the thyroid gland include trauma such as fine-needle aspiration and foreign bodies.…”

Section: Discussionmentioning

confidence: 99%

Neck abscess as the initial manifestation of pharyngeal cancer

Uhliarova¹,

Hajtman

2016

JMM Case Reports

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Introduction: Pharyngeal carcinoma and neck abscesses are not uncommon, but neck infection as the initial presentation of primary head and neck cancer is rare, and these patients risk potential misdiagnosis.Case presentation: We report our experience with two patients who had an unusual first presentation of pharyngeal cancer -a deep neck infection and a relapsing abscess of the thyroid gland. Conclusion:Our case series demonstrates the need for meticulous physical examination of the head and neck in all patients presenting with neck abscess. It is important to consider malignant tumour as a possible cause of deep neck infection and an abscess of the thyroid gland. Diagnosis and subsequent treatment is delayed if malignancy is not clinically suspected.

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Section: Discussionmentioning

confidence: 99%

Neck abscess as the initial manifestation of pharyngeal cancer

Uhliarova¹,

Hajtman

2016

JMM Case Reports

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“…A TA é mais comum em crianças do que em adultos, nos portadores de doença tireoidiana prévia (neoplasia tireoidiana, tireoidite de Hashimoto (TH) e bócio multinodular) ou naqueles com anomalias congênitas, como persistência do ducto tireoglosso ou presença de fístula do seio piriforme; sendo esta última condição mais comum em crianças (5,11,13). Aproximadamente a metade dos pacientes com TA tem doença tireoidiana preexistente (11).…”

Section: Discussionunclassified

“…Uma gama de agentes etiológicos já foram descritos (1-4), todavia, os principais patógenos envolvidos são estreptococos e estafilococos (5). A infecção usualmente se expande para a tireóide de maneira direta por meio de estruturas adjacentes, ou a distância, por meio do sistema sangüíneo ou linfático.…”

Section: Introductionunclassified

“…A infecção usualmente se expande para a tireóide de maneira direta por meio de estruturas adjacentes, ou a distância, por meio do sistema sangüíneo ou linfático. Em pacientes pediá-tricos, as principais fontes de infecções são anomalias congênitas, como persistência do ducto tireoglosso e fístula do seio piriforme, levando principalmente ao acometimento tireoidiano unilateral esquerdo (6,7) e, em alguns casos, recorrência do quadro (5). Já no adulto, a disseminação hematogênica e linfática de infecção oriunda de vias aéreas superiores ou a distância para uma tireóide com alteração preexistente são as causas mais freqüentemente postuladas (8).…”

Section: Introductionunclassified

“…O tratamento cirúrgico pode variar desde a drenagem ou ressecção cirúrgica por meio de pequena incisão para a colocação do dreno até raros casos de tireoidectomia parcial ou total. Fístu-las do seio piriforme devem ser removidas para prevenir recorrências da doença (1,5).…”

Section: Introductionunclassified

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Forma atípica de tireoidite supurativa aguda em paciente pediátrico: relato de caso

Torres

Medeiros

Neto

et al. 2008

Arq Bras Endocrinol Metab

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A tireoidite aguda é uma doença rara. Na infância associa-se principalmente a anormalidades congênitas com acometimento do lobo esquerdo. Na ausên-cia de tireoidopatia preexistente, a função tireoidiana geralmente está normal. Relatamos um caso de uma menina, 6 anos de idade, com tumoração associada a sinais flogísticos na região cervical anterior há 15 dias acompanhada de leucocitose com desvio à esquerda, VSH e TSH elevados. Não havia história prévia de tireoidopatia. A ultra-sonografia da região cervical foi sugestiva de abscesso tireoidiano. Realizou-se antibioticoterapia e drenagem cirúrgica com boa resposta, porém posteriormente a paciente evoluiu com hipotireoidismo clínico. O esofagograma não detectou fístula do seio piriforme e a ultra-sonografia controle revelou heterogeneidade do parênquima, levantando-se a possibilidade de tireoidite de Hashimoto. A importância do caso deve-se à sua apresentação incomum: ausência de anormalidades congênitas, acometimento difuso da tireóide, alteração da função tireoidiana e provável tireoidite de Hashimoto como fator predisponente da tireoidite aguda. ABSTRACT Atypical Form of Acute Suppurative Thyroiditis in Pediatric Patient: Case Report.Acute thyroiditis is an unusual disease. In pediatric patients it is usually associated with congenital abnormalities towards the unilateral envelopment of the left thyroid lobe. In general, in the absence of preexisting thyroid disease, the thyroid function is most often normal. It is here described a case of a sixyear-old girl who had presented a mass with flogistic signs in the anterior neck region for fifteen days, together with leukocytosis and increased levels of VSH and TSH. There was no evidence of previous thyroid disease and the cervical ultrasonography suggested thyroid abscess. Intravenous antibiotic and surgical dranaige were done with a good response, however, the patient developed clinical hypothyroidism aftherwards . Barium swallow did not demonstrate pyriform sinus fistula and the follow-up ultrasonography revealed heterogeneous internal texture suggesting Hashimoto´s Thyroiditis. The relevance of this case is due to its unusual findings: the absence of congenital abnormalities, bilateral envelopment of thyroid lobes, hypothyroidism and a probable Hashimoto´s Thyroiditis as a predisposing factor for acute thyroiditis. Arq Bras Endocrinol Metab 2008; 52/4:701-706)

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A safe and effective surgical method for complex pyriform sinus fistula

Yue

Lei

et al. 2022

Laryngoscope Investig Oto

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Objective This article aims to propose a new surgical method for the treatment of pyriform fistula, especially for the complex pyriform fistula. Methods A total of 36 patients with pyriform fistula underwent the procedure between August 2017 to October 2020. Surgery was performed by the senior authors using the same technique at the same clinical center for all patients. The median follow‐up time was 33 months. Meantime, we collected information on patients with pyriform fistula using traditional surgical methods in our hospital from April 2015 to November 2018 for comparison. Results The surgery was successfully completed in 36 patients. In all, 32 patients had a history of multiple incisions and drainage, 16 patients had a history of surgical resections, and two patients had a history of cauterization of the internal fistula. Compared with traditional surgical methods, our new surgical method greatly shortens the length of the surgical incision (4.3 vs. 5.5, p < 0.0001), reduces the operation time (8.1 vs. 27.1, p < 0.0001), and reduces the blood loss (103.2 vs. 196.8, p < 0.0001). None of the 36 patients in this study had complications such as pharyngeal fistula, recurrent laryngeal nerve paralysis, or hypothyroidism. The mean follow‐up duration after the excision of the lesion was 34.1 months. To date, no patients have relapsed. Conclusion Our experience showed that this surgical technique could be used to completely remove the fistula, and it was easier to perform than the conventional strategies. These treatment options result in less trauma and reliable results, especially for complex pyriform fistulas. Level of evidence IV

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Acute suppurative thyroiditis in children secondary to pyriform sinus fistula

Cited by 33 publications

References 13 publications

Neck abscess as the initial manifestation of pharyngeal cancer

Neck abscess as the initial manifestation of pharyngeal cancer

Forma atípica de tireoidite supurativa aguda em paciente pediátrico: relato de caso

A safe and effective surgical method for complex pyriform sinus fistula

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