Mootz W, Bleif H
HNO. 1980 Jun;28(6):197-200.
We report an unusual case of simultaneous occurrence of peritonsillar abscess due to Streptococcus viridans with an aneurism of the internal carotid artery. Inflammation caused by the abscess was so marked that its operative treatment unexpectedly uncovered the aneurism. We believe that the aneurism probably resulted from lymphatic spread of inflammation. Although rarely occurring, such aneurisms are clinically very important: the danger of misinterpreting symptoms as those of a peritonsillar or retropharyngeal abscess is great, as is that of bleeding caused by incising an abscess overlying the aneurism. This is particularly important in children due to the frequent occurrence of tonsil infections in this age group. The differential diagnosis of posterior or lateral pharyngeal swellings in children does not generally include aneurisms since these seldom occur in children and are overall rare in occurrence.
我们报告了一例罕见病例,即由草绿色链球菌引起的扁桃体周围脓肿与颈内动脉动脉瘤同时出现。脓肿引起的炎症非常明显,以至于其手术治疗意外地发现了动脉瘤。我们认为,动脉瘤可能是由炎症的淋巴扩散所致。尽管这种动脉瘤很少见,但在临床上非常重要:将症状误诊为扁桃体周围或咽后脓肿的风险很大,切开覆盖在动脉瘤上的脓肿导致出血的风险也很大。由于该年龄组扁桃体感染频繁发生,这在儿童中尤为重要。儿童咽后部或侧部肿胀的鉴别诊断通常不包括动脉瘤,因为这些在儿童中很少发生,总体发生率也很低。