Occult congenital pyriform sinus fistula causing recurrent left lower neck abscess

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background. Congenital pyriform sinus fistula (CPSF) is a rare branchial pouch anomaly; it has the characteristic of left-sided predominance and is not always detected until complications such as neck abscess or acute suppurative thyroiditis resulted. Method. Seven sequential cases of CPSF, including five adults and two children, causing recurrent left lower neck abscess were reported. All of these patients had past histories of misdiagnosis: the intervals from the onset of symptoms to correct diagnosis ranged from 3 years to 34 years with an average of 20 years. Results. After barium swallow study and direct laryngoscopic examination in the quiescent stage of infection, the CPSFs of these seven patients were successfully excised with or without catheter guide. Conclusion. The key to diagnosis of CPSF is a high index of suspicion by the clinician. CPSF should be considered in the differential diagnosis of a neck abscess, especially if it is recurrent and left-sided.

Original languageEnglish
Pages (from-to)671-676
Number of pages6
JournalHead and Neck
Volume21
Issue number7
DOIs
Publication statusPublished - 1999

Fingerprint

Pyriform Sinus
Abscess
Fistula
Neck
Suppurative Thyroiditis
Barium
Deglutition
Diagnostic Errors
Differential Diagnosis
Catheters
Infection

Keywords

  • Acute suppurative thyroiditis
  • Branchial remnant
  • Cervical draining sinus
  • Neck abscess
  • Pyriform sinus fistula

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Occult congenital pyriform sinus fistula causing recurrent left lower neck abscess. / Lee, Fei Peng.

In: Head and Neck, Vol. 21, No. 7, 1999, p. 671-676.

Research output: Contribution to journalArticle

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abstract = "Background. Congenital pyriform sinus fistula (CPSF) is a rare branchial pouch anomaly; it has the characteristic of left-sided predominance and is not always detected until complications such as neck abscess or acute suppurative thyroiditis resulted. Method. Seven sequential cases of CPSF, including five adults and two children, causing recurrent left lower neck abscess were reported. All of these patients had past histories of misdiagnosis: the intervals from the onset of symptoms to correct diagnosis ranged from 3 years to 34 years with an average of 20 years. Results. After barium swallow study and direct laryngoscopic examination in the quiescent stage of infection, the CPSFs of these seven patients were successfully excised with or without catheter guide. Conclusion. The key to diagnosis of CPSF is a high index of suspicion by the clinician. CPSF should be considered in the differential diagnosis of a neck abscess, especially if it is recurrent and left-sided.",
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