Radiologic Findings of a Recurrent Thyroidal and Perithyroidal Soft Tissue Infections Associated with a Pyriform Sinus Fistula: A Case Report.
10.16956/kjes.2008.8.3.206
- Author:
Heung Cheol KIM
1
;
Im Kyung HWANG
;
Sook NAMKUNG
;
Myung Sun HONG
;
Ji Yeon JANG
;
Ji Yeon LEE
;
Hee Rok JEONG
Author Information
1. Department of Radiology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea. khc@hallym.or.kr
- Publication Type:Case Report
- Keywords:
Pyriform sinus;
Congenital fistula;
Thyroiditis;
CT
- MeSH:
Abscess;
Adolescent;
Barium;
Fistula*;
Humans;
Inflammation;
Laryngoscopy;
Male;
Neck;
Pyriform Sinus*;
Soft Tissue Infections*;
Thyroid Gland*;
Thyroiditis;
Thyroiditis, Suppurative;
Tomography, X-Ray Computed
- From:Korean Journal of Endocrine Surgery
2008;8(3):206-209
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We report here on a case of a recurrent left anterior neck infection and focal left suppurative thyroiditis that were associated with a congenital pyriform sinus fistula (PSF) in an 18-year-old male. Acute suppurative thyroidits is a very rare clinical condition and it is usually caused by infection that's derived from infected perithyroidal tissue or a congenital internal fistula. The PSF can lead to recurrent episodes of neck inflammation and abscess, and it is the most common cause of acute suppurative thyroiditis in young man. In this current case, the CT scan showed an air-containing tract of a PSF from the left pyriform sinus to the left thyroid gland and the perithyroidal soft tissue. The CT scan also showed a neck inflammatory infiltration or abscess along the course of the sinus tract. The focal low density of the thyroid parenchyma was seen and this was suggestive of suppurative thyroiditis. Barium esophagography demonstrated the fistulous tract in the PSF. We performed laryngoscopy, and the internal opening of the pyriform sinus fistula was successfully cauterized with AgNO3 and the post procedure course was fair. When an air-containing tract and a recurrent inflammatory infiltration or abscess are present at the left anterior neck with including the thyroid and perithyroidal soft tissue, a PSF should be strongly suspected.