颈部侧位X光肿块影像表现的扁桃腺周围脓疡(附病例报告)
Peritonsillar Abscess Presenting as a Mass Shadow on Lateral Neck Radiograph: A Case Report

作者: 陈映庄 :台北医学大学附属医院儿科; 阮仙利 :浙江省立同德医院儿科; 陈中明 :台北医学大学医学院医学系儿学科;

关键词: 扁桃腺周围脓疡放射诊断颈部侧位X光片Peritonsillar Abscess Diagnostic Radiology Lateral Neck Radiograph

摘要: 背景:扁桃腺周围脓疡的影像学诊断方式以计算机断层为主,以颈部侧位X光片影像诊断的报告尚少,本文目的是报告一个可以用颈部侧位X光片诊断扁桃腺周围脓疡的方法。方法:我们回顾了扁桃腺周围脓疡的临床症状以及影像学诊断文献,对照我们所报告的病例,探讨更有效的诊断方法。结果:计算机断层扫描虽然对于扁桃腺周围脓疡仍然是很准确的诊断工具,但是颈部侧位的X光片结合临床症状有很好的诊断价值。结论:我们的观察发现,颈部侧位X光片对于诊断扁桃腺周围脓疡以及排除其它颈部感染,经济且快速,在临床上有非常好的诊断价值。

Abstract: Background: Lateral neck radiograph is the most significant radiographic examination performed in a child with a suspected pharyngeal lesion. Methods: A 10-year-old boy suffered from severe sore throat with drooling and could not open mouth for 1 day. He complained of difficulty initiating swallowing even swallowing own saliva. Results: A lateral neck radiograph showed a mass shadow behind the posterior border of the mandibular ramus. Contrast-en- hanced CT showed a rim-enhanced hypodense mass (1.5 × 1.3 cm) at right superio-lateral tonsillar fossa. Endoscopy revealed a visible bulge of the right tonsil. Peritonsillar abscess was consequently diagnosed. Conclusions: A properly positioned lateral neck radiograph with a good imaging quality is a useful modality in the preliminary diagnosis of peritonsillar abscess.

文章引用: 陈映庄 , 阮仙利 , 陈中明 (2013) 颈部侧位X光肿块影像表现的扁桃腺周围脓疡(附病例报告)。 亚洲儿科病例研究, 1, 20-22. doi: 10.12677/ACRP.2013.12005

参考文献

[1] K. Ungkanont, R. F. Yellon, J. L. Weissman, et al. Head and neck space infections in infants and children. Otolaryngology—Head and Neck Surgery, 1995, 112(3): 375-382.

[2] S. Schraff, J. D. McGinn and C. S. Derkay. Peritonsillar abscess in children: A 10-year review of diagnosis and management. In- ternational Journal of Pediatric Otorhinolaryngology, 2001, 57(3): 213-218.

[3] NR Friedman, RB Mitchell, KD Pereira, et al. Peritonsillar abscess in early childhood. Presentation and management. Ar- chives of Otolaryngology—Head and Neck Surgery, 1997, 123 (6): 630-632.

[4] F. S. Herzon. P. Harris. Mosher award thesis. Peritonsillar abscess: Incidence, current management practices, and a proposal for treatment guidelines. Laryngoscope, 1995, 105(8): 1-17.

[5] K. R. Millar, D. W. Johnson, D. Drummond and J. D. Kellner. Suspected peritonsillar abscess in children. Pediatric Emergency Care, 2007, 23(7): 431-438.

[6] R. F. Yellon. Head and neck space infections. In: C. D. Blue- stone, M. L. Casselbrant, S. E. Stool, et al., Eds., Pediatric Oto- laryngology. 4th Edition, Philadelphia: Saunders, 2003: 1681.

[7] I. Brook. Microbiology and management of periton-sillar, retro- pharyngeal, and parapharyngeal abscesses. Journal of Oral and Maxillofacial Surgery, 2004, 62(12): 1545-1550.

[8] G. Szuhay, T. L. Tewfik. Peritonsillar abscess or cellulitis? A clinical comparative paediatric study. Journal of Otolaryngology, 1998, 27(4): 206-212.

[9] M. Tebruegge, N. Curtis. Infections related to the upper and middle airways. In: S. S. Long, L. K. Pickering and C. G. Prober, Eds., Principles and Practice of Pediatric Infectious Diseases. 3rd Edition, New York: Elsevier Saunders, 2012: 205.

[10] J. P. Simons, B. F. Branstetter 4th and D. L. Mandell. Bilateral peritonsillar abscesses: Case report and literature review. Ame- rican Journal of Otolaryngology, 2006, 27(6): 443-445.

[11] A. Safdar, J. P. Hughes, R. M. Walsh and M. Walsh. Bilateral peritonsillar abscess revisited. Ear, Nose & Throat Journal, 2005, 84(12): 791-793.

[12] J. F. Fiechtl, L. B. Stack. Images in clinical medicine. Bilateral peritonsillar abscesses. The New England Journal of Medicine, 2008, 358(23): e27.

[13] K. S. Patel, A. S. hmad, G. O’Leary and M. Michel. The role of computed tomography in the management of peritonsillar ab- scess. Otolaryngology—Head and Neck Surgery, 1992, 107(6): 727-732.

[14] P. M. Scott, W. K. Loftus, J. Kew, et al. Diagnosis of peritonsil- lar infections: A prospective study of ultrasound, computerized tomography and clinical diagnosis. Journal of Laryngology and Otology, 1999, 113(3): 229-232.

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