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Occult pharyngeal perforation secondary to ‘pencil injury’

Published online by Cambridge University Press:  29 June 2007

David A. Smyth ,
John Fenton ,
Conrad Timon  and
Donald P. McShane
David A. Smyth*
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, National Children's Hospital, Dublin, Ireland.
John Fenton
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, National Children's Hospital, Dublin, Ireland.
Conrad Timon
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, National Children's Hospital, Dublin, Ireland.
Donald P. McShane
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, National Children's Hospital, Dublin, Ireland.
*
Address for correspondence: Mr. David Smyth, 55 Tonlegee Road, Coolock, Dublin 5, Ireland.
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Abstract

Palatopharyngeal injuries due to impaction of rigid objects held in the mouth are common. Most are essentially innocuous injuries requiring no specific treatment. However, there is the potential for perforation of the pharyngeal wall with the subsequent development of serious infection such as retropharyngeal abscess or mediastinitis. This possibility is more likely to be suspected in the presence of a visible laceration or puncture wound at the site of impact in the mouth or pharynx. We report three cases in which occult pharyngeal perforation occurred without any clinical signs of breech of the pharyngeal wall. In all cases a lateral soft tissue neck X-ray was diagnostic of perforation, showing the presence of retropharyngeal air. We, therefore, advocate the routine performance of soft tissue neck X-rays in all patients who present with a history of falling on a rigid object held in the mouth.

Keywords

PharynxWounds and injuriesRadiology
Type
Radiology in Focus
Information
The Journal of Laryngology & Otology , Volume 110 , Issue 9 , September 1996 , pp. 901 - 903
Copyright
Copyright © JLO (1984) Limited 1996

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