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Case of Retropharyngeal Abscess

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This post is an answer to the Case – Severe Sore Throat, Painful Swallowing and Fever

Interpretation

  • Widened retropharyngeal soft tissues
  • A localized gas locule in the retropharyngeal space

Lateral radiograph of the neck shows thickening of the retropharyngeal soft tissues and localized gas lucency within suggestive of a retropharyngeal abscess.
Lateral radiograph of the neck shows thickening of the retropharyngeal soft tissues (arrows) and localized gas lucency within (arrowheads) suggestive of a retropharyngeal abscess.

A contrast enhanced CT neck was performed (image below) which showed:

  • Prominent retropharyngeal soft tissues
  • Large rim-enhancing lesions with necrotic centre in retropharyngeal soft tissue consistent with an abscess
Contrast enhanced axial CT of the neck shows soft tissue thickening and pus collections in retropharyngeal space and right hypopharynx
Contrast enhanced axial CT of the neck shows soft tissue thickening and pus collections in retropharyngeal space (arrows) and right hypopharynx (arrowheads)

Diagnosis

Lateral radiograph of the neck shows thickening of the retropharyngeal soft tissues (arrows) and localized gas lucency within (arrowheads) suggestive of a retropharyngeal abscess.

Key Points

  • Gas locules within widened retropharyngeal soft tissues on plain radiographs in the appropriate clinical setting is highly suggestive of retropharyngeal abscess.
  • CT is the imaging modality of choice for exact anatomical localization and extent of the abscess.
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