Retropharyngeal abscess in an adult

Background. Retropharyngeal abscess occurs mainly in early childhood as a result of suppuration of the retropharyngeal lymph nodes and proceeds as an acute, highly symptomatic process. It is extremely rare for a retropharyngeal abscess to occur in adults after injury to the posterior pharyngeal wall by a foreign body or as a result of an inflammatory process. In these cases, the condition often has a latent chronic course, which leads to diagnostic errors and, as a result, to a late start of adequate treatment. Due to the peculiarities of the topography of the retropharyngeal space, such complications of the retropharyngeal abscess as mediastinitis, aspiration pneumonia, airway obstruction, jugular vein thrombophlebitis, and sepsis can develop.
Case description. Patient M., female, 38 years old, was admitted with complaints of throat pain on swallowing on the left, pain in the upper third of the lateral neck on the left, headache, and fatigue. No purulent discharge was obtained with fine needle aspiration in the region of the posterior wall of the oropharynx on the left, in the place of the most prominent bulging. Contrast-enhanced computed tomography of the neck demonstrated an additional low-density structure in the retropharyngeal space. Lack of contrast enhancement of the internal jugular vein on the left with presumptive compression (previously, the lumen was narrowed to thread-like). The submandibular, parapharyngeal, and retropharyngeal spaces were opened on the left through the cervical collar incision (about 5 ml of purulent to serous discharge was obtained from the retropharyngeal space, and purulent discharge was obtained from the previously performed incision when washed through the drainage from the side of the oral cavity). Outcomes. The 38-year-old patient successfully underwent surgical treatment of a retropharyngeal abscess opened with a combined approach. There were no complications in the postoperative period.
Key words: retropharyngeal abscess, abscess, retropharyngeal space, retropharyngeal, prevertebral soft tissues, cold abscess
Conflicts of interest. The author have no conflicts of interest to declare.
Funding. There was no funding for this study