Penetrating Pharyngeal Injuries in Children: Trivial Trauma Leading to Devastating Complications

Pediatr Surg Int. 2005 Jun;21(6):432-5. doi: 10.1007/s00383-005-1447-0. Epub 2005 May 13.

Abstract

Pharyngeal perforations are uncommon in children and are usually secondary to instrumentation or external penetrating injuries. A delay in management can lead to life-threatening complications such as retropharyngeal abscess, mediastinitis, and airway compromise. We report three children who had pharyngeal perforation due to apparently innocuous injury and who developed serious complications. A high index of suspicion for a significant pharyngeal injury, use of lateral soft-tissue x-ray films of the neck, and flexible endoscopy in the emergency room can assist in early diagnosis when evaluating patients with oropharyngeal and penetrating neck injury. Prompt administration of broad-spectrum antibiotics, local drainage, and debridement can avert life-threatening complications.

MeSH terms

  • Abscess / etiology
  • Adolescent
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Mediastinal Diseases / etiology
  • Mediastinal Emphysema / etiology*
  • Pharynx / injuries*
  • Pharynx / surgery
  • Retropharyngeal Abscess / diagnostic imaging
  • Retropharyngeal Abscess / etiology*
  • Subcutaneous Emphysema / etiology*
  • Tomography, X-Ray Computed
  • Wounds, Penetrating / complications*
  • Wounds, Penetrating / surgery