Tsai Chia-Chang, Lui Chun Chung, Chung Mei-Yung, Ko Tan-Yung
Department of Pediatrics, Chang Gung Children's Hospital, Kaohsiung, Taiwan, Republic of China.
Am J Perinatol. 2003 Jul;20(5):227-31. doi: 10.1055/s-2003-42338.
A retropharyngeal abscess rarely occurs in the neonate. We report a neonate without apparent trauma who presented with a left neck mass and respiratory distress at the fourth day of age. A lateral neck X-ray revealed a widened retropharyngeal space. A neck computed tomography (CT) scan revealed a space-occupying lesion with air content in the left retropharyngeal area, although direct laryngoscopy, endoscopy, and a pharyngoesophagogram did not demonstrate the presence of any fistula tract. Due to the high index of suspicion for an aero-digestive tract fistula, diluted contrast medium was injected into the cyst while performing a CT-guided aspiration, and opacification was found in the oropharynx, thus a branchial-cleft sinus appeared to be most likely. The follow-up neck CT scan revealed no evidence of any recurrence. We suggest that CT-guided aspiration and cystography are useful for the diagnosis and treatment of some neonatal neck cystic lesions.
咽后脓肿在新生儿中很少见。我们报告一例新生儿，无明显外伤史，于出生后第4天出现左侧颈部肿块及呼吸窘迫。颈部侧位X线片显示咽后间隙增宽。颈部计算机断层扫描（CT）显示左侧咽后区有一含气的占位性病变，尽管直接喉镜检查、内镜检查及咽食管造影均未发现任何瘘管。由于高度怀疑存在气消化道瘘，在CT引导下穿刺囊肿时注入稀释造影剂，发现口咽内有造影剂显影，因此最可能为鳃裂窦。随访颈部CT扫描未发现复发迹象。我们认为CT引导下穿刺及囊肿造影对某些新生儿颈部囊性病变的诊断和治疗有用。
