Rationelle Diagnostik kindlicher Halsabszesse1

Kühnemann, S.; Keck, Tobias; Riechelmann, Herbert; Rettinger, Gerhard

doi:10.1055/s-2001-13891

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…[34][35][36][37][38][39] Adequate clinical examination is required to ensure the correct diagnosis is at least suspected and then confirmed with the appropriate investigations, which are discussed below. 40 The symptom complex does not appear to differ when surgical drainage is not performed or the drainage is negative. 9 The most important factor is early diagnosis in order to prevent the significant morbidity that the condition can produce including airway obstruction and death.…”

Section: Presentationmentioning

confidence: 95%

“…A negative result cannot therefore refute the presence of an RPA or other deep space abscess in the neck, but the investigation, if positive, can provide a simple, cheap and non-irradiating form of investigating the patient. 40,46,47 Some authors have presented it in a positive light in the context of RPAs, 48 even rating it above CT scanning 49 and this is simply due to its ability to distinguish fluid from solid. One study used colour Doppler ultrasonography to effectively confirm the diagnosis in a group of 50 patients.…”

Section: Ultrasonographymentioning

confidence: 99%

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Paediatric retropharyngeal abscess

2004

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Retropharyngeal abscess (RPA) is an uncommon condition with the potential for significant morbidity and mortality if not detected early. The authors present a case report of a 19-month-old child who presented with the common clinical features of a retropharyngeal abscess and in whom the diagnosis was not established by examination and ultrasonography. This led to a delay in appropriate management until a computed tomography (CT) scan was performed under general anaesthesia. The scan demonstrated the diagnosis and surgical drainage was performed under the same anaesthetic. The child subsequently made a complete recovery. The investigation and treatment of RPAs is a matter of some debate and the authors review the recent literature to determine the best management strategy.

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Section: Presentationmentioning

confidence: 95%

Section: Ultrasonographymentioning

confidence: 99%

Paediatric retropharyngeal abscess

2004

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“…Wie auch unser Fallbericht zeigt, muss eine Verbreiterung des Retropharyngealraumes über 7 mm und eine Verbreiterung des Retrotrachealraumes über 22 mm an einen entzündlichen Prozess dieser anatomischen Räume denken lassen. Die CT ist das bildgebende Verfahren der Wahl bei der Beurteilung von tiefen Halsabszessen [14]. Eine CT des Halses mit Kontrastmittel kann hilfreich sein beim Unterscheiden zwischen einer phlegmonösen Entzündung und einem Abszess sowie beim genauen Lokalisieren und Identifizieren eines entzündlichen Prozesses und dessen Ausbreitung entlang der zervikalen Faszien und Halsweichteile.…”

Section: Fallberichtunclassified

Ungewöhnliche Lage einer retropharyngeal eingespießten Fischgräte

Giger

Landis²,

Dulguerov³

2004

Laryngorhinootologie

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ZusammenfassungWir berichten über den Fall einer 34-jährigen Frau mit einem retropharyngealen Abszess, verursacht durch eine Fischgrätever-letzung. Trotz der typischen Anamnese und Symptome (Nackenstarre, Aphagie) eines retropharyngealen Abszesses illustriert dieser Fall die Wichtigkeit der radiologischen Bildgebung (Computertomographie) hinsichtlich der Lokalisation des Fremdkör-pers und der Planung dessen chirurgischer Entfernung. Die Fischgräte war bei der klinischen Untersuchung nicht sichtbar. In der Computertomographie des Halses fand sich ein ungewöhnlicher, schräg liegender, röntgendichter Fremdkörper im Retropharyngealraum. Nach pharyngoskopischer Abszesseröff-nung konnte die Fischgräte mit Erfolg entfernt werden. Anhand dieses Falles sollen Ursache, klinische Zeichen, Symptome, Diagnostik, Behandlung und Komplikationen retropharyngealer Abszesse kurz diskutiert werden. SchlüsselwörterRetropharyngealer Abszess´Erwachsene´Fremdkörper´Fisch-gräte´pharyngoskopische Entfernung AbstractThe case of a 34-year-old otherwise healthy woman with retropharyngeal abscess due to a fishbone injury and presenting with neck stiffness and aphagia without visualization of a pharyngeal mucosal lesion is reported. The case illustrates that sore throat with symptoms out of proportion to oropharyngeal findings should prompt a search for pathologies other than simple pharyngotonsillitis. Other typical symptoms of a retropharyngeal abscess are high fever, dysphagia, hot potato voice and, less commonly, dyspnea and sepsis. Retropharyngeal abscess in adults occurs most often as a complication of a spread of infection from a pharyngeal focus, a foreign body injury, an iatrogenic trauma due to tracheal intubation or endoscopy, and blunt or perforating neck trauma. Contrary to children, a retropharyngeal abscess in adults without loco-regional infection or preceding trauma is very rare. This case illustrates how important imaging investigations (CT-scan) are in order to locate foreign bodies and to decide on surgical management. Aetiology, presenting signs, symptoms, methods of diagnosis, treatment and complications of a retropharyngeal abscess are briefly discussed.

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