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Life-threatening pediatric retropharyngeal abscess: A case report on delayed complication of endoscopic fishbone removal in an infant

Year: 2025

Type: article

Abstract: RATIONALE: Retropharyngeal abscesses (RPAs) following fish bone ingestion are extremely rare in infants under 2 years, with limited cases reported worldwide. Given the anatomical vulnerability and diagnostic challenges faced by infants, this gap in knowledge is critical. No previous reports have described life-threatening delayed RPA caused by endoscopic pharyngeal injury without a retained foreign body, which is a critical omission in the postoperative safety protocols. Our study details a life-threatening delayed RPA caused by posterior pharyngeal wall injury after endoscopic removal of a fish bone, highlights the critical role of postoperative imaging, which is frequently overlooked in pediatric practice, and contributes to the sparse literature on severely delayed RPAs in infants after fish bone ingestion. PATIENT CONCERNS: An 18-month-old girl presented with 6 months of recurrent hoarseness, stridor, and progressive respiratory distress. DIAGNOSES: The diagnostic evaluations included laboratory studies and imaging examinations, and imaging revealed a large RPA causing significant tracheal compression and pneumonia. INTERVENTIONS: Emergency management included intubation, mechanical ventilation, broad-spectrum antibiotics, and surgical drainage. OUTCOMES: Surgical drainage and targeted antibiotic therapy resolved inflammation. LESSONS: This novel case of delayed RPA after endoscopic foreign-body removal emphasizes the need for postoperative imaging, urgent surgical intervention, and enhanced caregiver education to prevent infant complications.

Source: Medicine

DOI: 10.1097/md.0000000000043664

Authors: Chenyang Xu, Xiaowen Liu, Yufen Guo, Suyang Wang

Institutions: Gansu Provincial Hospital, Gansu Provincial Maternal and Child Health Hospital, Lanzhou University Second Hospital, Lanzhou University

Language: English

Topic: Foreign Body Medical Cases

Subfield: Radiology, Nuclear Medicine and Imaging

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,950