Case of Retropharyngeal Abscess - Manual of Medicine

Case of Retropharyngeal Abscess

Post category:Spot Diagnosis - Case Asnwers
Post published:August 27, 2025

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.