URTI: Retropharyngeal Abscesses

Question 1

What is a Retropharyngeal Abscess?

Answer 1

Pus collection in Retropharyngeal space (back of throat)

Question 2

What are the causes of Retropharyngeal Abscesses? (2 things)

Answer 2

Caused by infections that drain to LATERAL Retropharyngeal Lymph Nodes:

1. Secondary to other URTIs / Otitis Media (S aureus / GAS)
2. Secondary to trauma (foreign body e.g fishbone / Endoscopy)

Question 3

What are the CF of Retropharyngeal Abscesses? (7 things)

Answer 3

1. Fever
2. Swollen Pharynx + Lymph nodes
3. Dysphagia + Odynophagia
4. SOB
5. Cough
6. Stridor
7. Neck pain / stiffness

Question 4

What investigations should you for for sus Retropharyngeal Abscesses? (3 things)

Answer 4

1. Bloods (FBC + Culture) (start wid dis)
2. CT Neck w Contrast (GOLD)
3. Lateral Neck XR

Question 5

What will be seen in a CT Neck w Contrast (GOLD) in Retropharyngeal Abscesses? (3 things)

Answer 5

1. Hypodense collection in retropharyngeal space (see pic)
2. Thickening of prevertebral space
3. Air / air-fluid levels

Question 6

What will be seen in a Lateral Neck XR in Retropharyngeal Abscesses? (2 things)

Answer 6

1. Widened retropharyngeal space (thickened soft tissue)
2. Gas in retropharyngeal space

Question 7

What are the management options for Retropharyngeal Abscesses? (3 things)

Answer 7

1. Airway management by intubation (if obst)
2. Surgical drainage
3. Abx (Ampicillin)

Question 8

What are the complications of Retropharyngeal Abscesses? (6 things)

Answer 8

1. Airway obst
2. Carotid artery rupture (bc carotid sheath extension)
3. Mediastinitis
4. Pericarditis
5. Pharyngitis
6. Sepsis