Retropharyngeal Abscess

The condition occurs, as a rule, in infants or young children. Upper respiratory infection causes adenitis in the retropharyngeal lymph nodes, which suppurate. The abscess is limited to one side of the midline by the median raphe of buccopharyngeal fascia, which is firmly attached to the prevertebral fascia (Fig. 30.1). CLINICAL FEATURES The infant or child is obviously ill and has a high temperature. Dysphagia is evinced by dribbling, and there may be stridor.The head is often held to one side. Inspection and palpation of the posterior pharyngeal wall reveals a smooth bulge, usually on one side of the midline TREATMENT Antibiotics should be given in full doses. Incision of the abscess should be carried out without delay. General anaesthesia is advisable but requires great skill and gentleness—rupture of the abscess may prove fatal as a result of aspiration of pus. The abscess is incised through the pharyngeal wall and pus sent for bacteriological examination.

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