대한흉부영상의학회 Korean Society of Thoracic Radiology GuerBet

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대한흉부영상의학회 Weekly Case 검색
대한흉부영상의학회 Weekly Case 검색
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Weekly Chest CasesArchive of Old Cases

Case No : 19 Date 1998-03-09

  • Courtesy of Jae-Woo Song, M.D.,Joon Beom Seo, M.D. / Boramae Hospital, Seoul National University Hospital
  • Age/Sex 60 / M
  • Chief ComplaintChief complaints: buccal swelling, progressed swallowing difficulty, fever for 4 days
  • Figure 1
  • Figure 2

Diagnosis With Brief Discussion

Diagnosis
Retropharyngeal abscess with mediastinal extension
Radiologic Findings
Brief Review
Many cases of acute mediastinitis are fulminating and lethal. The most common causes are esophageal perforation or postoperative infection. Spontaneous perforation (Boerhaave's syndrome) occurs after episodes of severe vomiting. The usual site of rupture is the lower 8 cm of the esophagus. Other causes are leakage from the esophagus into the mediastinum through necrotic neoplasm and extension of infection from adjacent structures, particularly the neck, pharynx, or teeth.
The main radiographic manifestations of acute mediastinitis are widening of the mediastinum, pneumomediastinum, obliteration of fat planes, localized fluid collections, and abscess formation. All of these features are better demonstrated on CT scans than on plain radiographs.
Retropharyngeal space lies between the pharyngobasilar and prevertebral fasciae. This space is potential space and normally extends to upper mediastinum. Through this potential space, infection in retropharyngeal space can spread to mediastinum.
References
Keywords
Mediastinum, Infection, Retropharyngeal abscess with mediastinal extension

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