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The effectiveness of conservative management for retropharyngeal abscesses greater than 2 cm
OBJECTIVES: Conservative management for retropharyngeal abscesses <2 cm is now a first line option. It is unclear if conservative management can be used to manage larger abscesses without increased morbidity and mortality. STUDY DESIGN: A prospective case series was performed from 2012 to 2015 by...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5065001/ https://www.ncbi.nlm.nih.gov/pubmed/27761237 http://dx.doi.org/10.1016/j.amsu.2016.10.001 |
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author | Khudan, A. Jugmohansingh, G. Islam, S. Medford, S. Naraynsingh, V. |
author_facet | Khudan, A. Jugmohansingh, G. Islam, S. Medford, S. Naraynsingh, V. |
author_sort | Khudan, A. |
collection | PubMed |
description | OBJECTIVES: Conservative management for retropharyngeal abscesses <2 cm is now a first line option. It is unclear if conservative management can be used to manage larger abscesses without increased morbidity and mortality. STUDY DESIGN: A prospective case series was performed from 2012 to 2015 by the Otolaryngology department of the San Fernando General Hospital involving pediatric patients who presented with retropharyngeal abscesses. All patients were initially treated with antibiotics alone. METHODS: Patients with clinical features and CT scan confirmation of a retropharyngeal abscess were included in the study. Those who improved clinically and biochemically within 48 h continued to be treated conservatively and those who deteriorated had surgical intervention. RESULTS: Sixteen patients fulfilled the inclusion criteria. Most patients were Afro Trinidadian males between the ages of two and five who were also found to be iron deficient. Drooling was a sensitive predictor for the presence of an abscess but did not indicate the need for drainage. Hoarseness was the clinical feature that prompted surgical intervention. Sixty three percent of patients had an abscess >2 cm of which 90% improved within 48 h. One patient required surgical drainage with no increase in morbidity or mortality. CONCLUSION: Conservative management of retropharyngeal abscesses >2 cm can be offered to patients during the first 48 h. If the patient demonstrates clinical and biochemical improvement, antibiotics alone can be continued. If the patient deteriorates, surgical drainage can be subsequently performed with no increase in morbidity and mortality. |
format | Online Article Text |
id | pubmed-5065001 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-50650012016-10-19 The effectiveness of conservative management for retropharyngeal abscesses greater than 2 cm Khudan, A. Jugmohansingh, G. Islam, S. Medford, S. Naraynsingh, V. Ann Med Surg (Lond) Original Research OBJECTIVES: Conservative management for retropharyngeal abscesses <2 cm is now a first line option. It is unclear if conservative management can be used to manage larger abscesses without increased morbidity and mortality. STUDY DESIGN: A prospective case series was performed from 2012 to 2015 by the Otolaryngology department of the San Fernando General Hospital involving pediatric patients who presented with retropharyngeal abscesses. All patients were initially treated with antibiotics alone. METHODS: Patients with clinical features and CT scan confirmation of a retropharyngeal abscess were included in the study. Those who improved clinically and biochemically within 48 h continued to be treated conservatively and those who deteriorated had surgical intervention. RESULTS: Sixteen patients fulfilled the inclusion criteria. Most patients were Afro Trinidadian males between the ages of two and five who were also found to be iron deficient. Drooling was a sensitive predictor for the presence of an abscess but did not indicate the need for drainage. Hoarseness was the clinical feature that prompted surgical intervention. Sixty three percent of patients had an abscess >2 cm of which 90% improved within 48 h. One patient required surgical drainage with no increase in morbidity or mortality. CONCLUSION: Conservative management of retropharyngeal abscesses >2 cm can be offered to patients during the first 48 h. If the patient demonstrates clinical and biochemical improvement, antibiotics alone can be continued. If the patient deteriorates, surgical drainage can be subsequently performed with no increase in morbidity and mortality. Elsevier 2016-10-10 /pmc/articles/PMC5065001/ /pubmed/27761237 http://dx.doi.org/10.1016/j.amsu.2016.10.001 Text en © 2016 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Research Khudan, A. Jugmohansingh, G. Islam, S. Medford, S. Naraynsingh, V. The effectiveness of conservative management for retropharyngeal abscesses greater than 2 cm |
title | The effectiveness of conservative management for retropharyngeal abscesses greater than 2 cm |
title_full | The effectiveness of conservative management for retropharyngeal abscesses greater than 2 cm |
title_fullStr | The effectiveness of conservative management for retropharyngeal abscesses greater than 2 cm |
title_full_unstemmed | The effectiveness of conservative management for retropharyngeal abscesses greater than 2 cm |
title_short | The effectiveness of conservative management for retropharyngeal abscesses greater than 2 cm |
title_sort | effectiveness of conservative management for retropharyngeal abscesses greater than 2 cm |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5065001/ https://www.ncbi.nlm.nih.gov/pubmed/27761237 http://dx.doi.org/10.1016/j.amsu.2016.10.001 |
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