Bilateral Pulmonary Pleural Fistula Combined With Traumatic Retro-Pharyngeal Abscess

Abstract

F 9-month-old male baby visited our hospital due to severe dyspnea that had developed 2 days previously. e had had a fever and a cough for approximately 4 weeks nd had undergone removal of a tack in the pharynx 3 eeks previously. The tack had been accidentally found on chest roentgenogram that had been taken in order to valuate the fever’s origin (Fig 1). The chest roentgenogram at admission (Fig 2) showed bnormal gas shadows from the retro-pharynx to the upper ediastinum, and there was bilateral mediastinal bulging ontours with internal gas formation. Computed tomography Fig 3) demonstrated bilateral empyema sacs communicating ith each other in the posterior mediastinal cavity; furtherore, there was air and necrotic materials in the mediastinal avity and in the empyema sacs. We performed an emergency peration through a right posterolateral thoracotomy. After ebridement of the purulent materials in the posterior medistinal and bilateral thoracic cavities, the pulmonary pleural stula of the right upper lobe and the retro-esophageal cavity ith a fistulous connection between the mediastinal pleura nd the left thoracic cavity were discovered. The patient underwent wedge resection of the right