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Hypoharyngeal injury in an infant from non-accidental trauma
Jonathan M Melzer1, Cristina M Baldassari2
1Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center, Portsmouth, VA, United States.
Insights
Non-accidental trauma often affects the head and neck in children, but otolaryngologists rarely see these initial injuries. This report highlights pediatric head and neck trauma presentations and management.
Area of Science:
- Pediatric Otolaryngology
- Child Abuse and Neglect
- Trauma Surgery
Background:
- Non-accidental trauma (NAT) is a recognized cause of pediatric injury, frequently involving the head and neck.
- Otolaryngologists (ENT specialists) may not always recognize NAT during initial patient encounters.
- Early identification and management are crucial for pediatric patients suffering from head and neck trauma.
Observation:
- A 3-month-old female infant presented with a hypopharyngeal injury.
- The infant was also diagnosed with an esophageal perforation.
- These injuries were indicative of non-accidental trauma.
Findings:
- The case highlights the potential for severe hypopharyngeal and esophageal injuries in infants due to non-accidental trauma.
- Otolaryngologic examination is vital for diagnosing subtle or severe presentations of NAT in children.
- Management strategies for such injuries require a multidisciplinary approach.
Implications:
- Increased awareness among otolaryngologists regarding NAT presentations in pediatric patients is necessary.
- Prompt diagnosis and intervention can improve outcomes for children with traumatic head and neck injuries.
- This case underscores the importance of considering non-accidental trauma in the differential diagnosis of pediatric neck and airway emergencies.
Abstract:
Non-accidental trauma is a sad but commonly described mechanism of injury in the pediatric literature. However, the otolaryngologist infrequently encounters the initial presentation of non-accidental trauma despite the fact that a significant percentage of injuries take place in the head and neck. This case report seeks to discuss otolaryngologic presentations of non-accidental trauma in the pediatric population as well as to discuss management strategies. The case of a 3 month old female with a hypopharyngeal injury and esophageal perforation is presented and discussed.