Pyriform Sinus Perforation in a Child after Falling with a Spoon Handle in the Mouth.
10.4266/kjccm.2013.28.3.214
- Author:
Joongbum CHO
1
;
Mi Ran PARK
;
Jihyun KIM
;
Han Sin JEONG
;
Kangmo AHN
Author Information
1. Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
child;
hypopharynx;
injury;
perforation;
pyriform sinus
- MeSH:
Anti-Bacterial Agents;
Child;
Contrast Media;
Fever;
Humans;
Hypopharynx;
Intubation, Intratracheal;
Mouth;
Pyriform Sinus;
Respiration;
Subcutaneous Emphysema;
Thorax;
Vomiting
- From:The Korean Journal of Critical Care Medicine
2013;28(3):214-217
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Pyriform sinus perforation is uncommon in children and most cases are secondary to iatrogenic causes such as endotracheal intubations. Due to this rarity, the management of these injuries is controversial. We report a case of pyriform sinus perforation in a 14-month-old boy who fell down with a spoon handle in the mouth and was successfully treated by transoral laryngomicrosurgery. Two hours after falling down, the patient had breathing difficulties and started vomiting. A chest X-ray showed subcutaneous emphysema and pneumomediastium. Esophagogram revealed leakage of contrast media at the hypopharynx. Although air leakage was reduced the next day, his fever became frequent even with conservative management of antibiotics. On the 4th hospital day, closure of pyriform sinus perforation was done by transoral laryngomicrosurgery. The patient became apyrexial by the 2nd post-operative day. On the 21th hospital day, the child was able to consume food orally without problems and was allowed to go home.
