Retropharyngeal Space Abscess (Foreign Body)

Epidemiology

Nearly 80% of all cases of swallowed pharyngeal and esophageal foreign bodies are seen in the pediatric population. Children and psychiatric patients may swallow a variety of foreign bodies such as coins, caps, and small toys. Senile and stuporous patients may inhale dental bridges or dentures. In adults, the most commonly swallowed foreign bodies are fish and chicken bones. These objects are usually lodged in areas of normal anatomic narrowing in the cricopharyngeal area, the aortic arch, or the distal esophagus. Most animal bones are lodged in the cricopharyngeal region.

Clinical Findings

Children present clinically with respiratory distress, drooling, or regurgitation but adults usually present with pain and dysphagia. Senile, psychiatric, or stuporous patients may present late with evidence of fever or sepsis.

Pathology

Sharp objects may perforate the pharynx or esophagus and migrate along tissue planes and compartments. This may result in abscess formation in the adjacent spaces such as the retropharyngeal space.