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Retropharyngeal abscess complicated by carotid artery rupture
Zainab Waggie1, Mark Hatherill, Alastair Millar
1Paediatric Intensive Care Unit (ZW, MH, HF, AA) and the Department of Paediatric Surgery (AM, AVDM), Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Insights
A rare retropharyngeal abscess complication, carotid artery rupture in a child, was successfully treated with surgical ligation. Early suspicion is key for prompt diagnosis and intervention in pediatric cases.
Area of Science:
- Pediatric Medicine
- Surgical Complications
- Vascular Surgery
Background:
- Retropharyngeal abscesses are infections in the throat's deep tissues.
- Complications are rare but can be life-threatening, including vascular involvement.
- Prompt recognition and management are crucial for favorable outcomes.
Purpose of the Study:
- To present a case of a pediatric retropharyngeal abscess complicated by carotid artery rupture.
- To highlight the importance of considering vascular complications in persistent or severe cases.
- To discuss the successful management of this rare event.
Main Methods:
- A descriptive case report of a 2-month-old girl.
- Surgical intervention involved ligation of the affected right common carotid artery.
- Clinical monitoring for neurologic sequelae post-intervention.
Main Results:
- The patient developed carotid arteritis, pseudoaneurysm, and rupture of the right carotid artery.
- Successful surgical ligation of the carotid artery was performed.
- The child experienced no subsequent neurologic deficits.
Conclusions:
- Carotid artery involvement is a rare but critical complication of retropharyngeal abscess.
- A high index of suspicion is warranted for delayed symptom resolution.
- Exclusion of carotid artery involvement is essential if symptoms persist or worsen.
Abstract:
OBJECTIVE: To report the case of a child with a retropharyngeal abscess complicated by carotid artery rupture. DESIGN: Descriptive case report. SETTING: Pediatric intensive care unit of a children's hospital. Patient: A 2-month old girl. INTERVENTION: Surgical ligation of the right common carotid artery was performed. MEASUREMENTS AND MAIN RESULTS: Carotid artery involvement is a rare but life-threatening complication of a retropharyngeal abscess. The child developed carotid arteritis, with pseudoaneurysm formation and acute rupture of the right carotid artery. Surgical ligation was performed, with no accompanying neurologic sequelae. A high index of suspicion is needed for the possibility of carotid space involvement if there is a delay in the resolution of symptoms, despite adequate treatment. CONCLUSION: If a retropharyngeal abscess extends into the carotid space or there is a slow resolution of symptoms, carotid artery involvement must be excluded.