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Imaging findings in acute neck infection due to pyriform sinus fistula

Y U Gan1, S L Lam

  • 1Department of Diagnostic Radiology, Singapore General Hospital, Singapore.

Annals of the Academy of Medicine, Singapore
|November 9, 2004
PubMed

Insights

Pyriform sinus fistula, a congenital abnormality, can cause acute neck infections in children. Imaging like CT, ultrasound, and barium swallow are valuable for diagnosis, especially with recurrent infections.

Area of Science:

  • Pediatric Surgery
  • Diagnostic Imaging
  • Congenital Abnormalities

Background:

  • Pyriform sinus fistula is a congenital branchial pouch abnormality.
  • It is often overlooked as a cause of acute neck infection in children.
  • Early diagnosis is crucial for effective management.

Purpose of the Study:

  • To evaluate the diagnostic value of ultrasound, computed tomography (CT), and barium esophagography.
  • To demonstrate the effectiveness of various imaging modalities in diagnosing pyriform sinus fistula.

Main Methods:

  • Retrospective review of preoperative imaging findings in 5 patients with surgically proven pyriform sinus fistula.
  • Imaging modalities included CT (all patients), barium esophagography (4 patients), and ultrasound (3 patients).

Main Results:

  • CT accurately depicted inflammation and identified the fistula in 2 cases.
  • Ultrasound correlated with CT findings and showed gas in the fistula in one instance.
  • Barium esophagography clearly delineated the fistula in 3 out of 4 cases.

Conclusions:

  • Ultrasound and CT are effective in showing acute neck infection and identifying pyriform sinus fistula.
  • Barium esophagography provides the clearest depiction of the fistula's presence and course.
  • Recurrent left-sided neck infections in children warrant investigation for pyriform sinus fistula.
Abstract

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