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Traumatic perforation of the hypopharynx--an unusual form of abuse

H P McDowell, D W Fielding

    Archives of Disease in Childhood
    |September 1, 1984
    PubMed

    Insights

    Extensive interstitial emphysema in infants, a rare sign of pharyngeal non-accidental trauma, requires careful diagnosis and management. This condition highlights the importance of recognizing subtle indicators of child abuse.

    Area of Science:

    • Pediatric Medicine
    • Trauma Surgery
    • Child Abuse Pediatrics

    Background:

    • Non-accidental trauma (NAT) in infants can manifest in various ways.
    • Pharyngeal injuries are often difficult to diagnose, especially in young children.
    • Interstitial emphysema is an uncommon but serious complication of neck trauma.

    Observation:

    • Two infant cases presented with extensive interstitial emphysema of the neck.
    • The emphysema was directly attributed to non-accidental trauma to the pharynx.
    • Clinical presentation included signs suggestive of airway compromise and neck swelling.

    Findings:

    • Diagnosis was confirmed through imaging and clinical examination.
    • Management involved supportive care and addressing the underlying trauma.
    • This presentation represents an unusual manifestation of child abuse.

    Implications:

    • Highlights the need for increased awareness of pharyngeal NAT in infants.
    • Emphasizes the importance of considering interstitial emphysema as a potential indicator of abuse.
    • Informs clinical practice regarding the diagnosis and management of severe neck trauma in pediatric patients.

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