Retropharyngeal abscess (retropharyngeal abscess) – is a purulent expansion of the lymph nodes and loose tissue of the pharyngeal space, limited by the prevertebral plate of the cervical fascia, buccal-pharyngeal fascia, fascia and tissue surrounding the neurovascular bundle of the neck.
It is formed as a result of suppuration of the lymph nodes and fiber of the pharyngeal space. The infection penetrates through the lymphatic tract from the side of the nasal cavity, nasopharynx, auditory tube and middle ear. Sometimes an abscess is a complication of influenza, measles, scarlet fever, and can also develop when the mucous membrane of the posterior pharyngeal wall is injured by a foreign body, solid food. It is observed, as a rule, in early childhood in emaciated and weakened babies.
Complaints of choking and sharp pain when swallowing are characteristic, while food does not often enter the nose. The patient refuses food. When an abscess is located in the nasopharynx, nasal breathing is disturbed, a closed nasal sound appears. When the abscess spreads to the lower parts of the pharynx, inspiratory dyspnea occurs, accompanied by wheezing, especially in the upright position of the patient. Body temperature reaches 39-40 gr. C. The forced position of the head is characteristic:
it is thrown back and tilted to the affected side. Infrequently there is swelling behind the angle of the mandible and along the anterior edge of the sternocleidomastoid muscle.
Complications. Acute edema of the entrance to the larynx or spontaneous opening with suffocation due to the ingress of pus into the cavity of the larynx; pus can spread to the region of large vessels of the neck or descend along the prevertebral fascia into the chest cavity and cause purulent mediastinitis or tracheal compression.
The diagnosis is confirmed by pharyngoscopy, which reveals a fluctuating swelling on the back of the pharynx. In the first days of the disease, a spherical protrusion of the posterior pharyngeal wall is located on one side, and later on, along the midline. In doubtful cases, a diagnostic puncture is performed.
Early opening of the pharyngeal abscess with subsequent antibacterial and detoxification therapy.