ABSTRACT
Acute neck swellings in a paediatric setting are often treated with antibiotics, proceeding to incision and drainage if an abscess is suspected. A variety of investigations are available and the causative organism can vary. A five-year retrospective study analysing trends in microbiology, antibiotic sensitivity, clinical evaluation and management of children presenting with an acute cervical abscess of four weeks duration or less was performed. The case notes of 175 children admitted between January 1996 and December 2000 to the acute surgical admission unit at the Royal Hospital of Sick Children, Glasgow were studied. During this period there were 90 males and 85 females with a mean age of three years (range: one month to 13 years). One hundred and twenty three (70%) children underwent surgery with pus being confirmed in 114 (93%) of cases. Ultrasound was performed in 70 (40%) patients with 48 proceeding to surgery. Positive culture of pus from abscess cavities revealed Staphylococcus aureus in 46% (85% sensitive to both flucloxacillin and erythromycin) and Streptococcus pyogenes in 15% (80% sensitive to penicillin and 75% to erythromycin). The role of investigations and the available treatment options are discussed.
Subject(s)
Abscess/epidemiology , Abscess/therapy , Abscess/microbiology , Acute Disease , Adolescent , Anti-Bacterial Agents/therapeutic use , Biopsy, Fine-Needle , Child , Child, Preschool , Drainage , Female , Humans , Infant , Infant, Newborn , Length of Stay/statistics & numerical data , Male , Neck , Retrospective Studies , Scotland/epidemiologyABSTRACT
Pre-tracheal air cysts or aeroceles are rare complications of tracheostomy. This is believed to be the first reported case in an adult presenting with a pre-tracheal air cyst 12 years after a tracheostomy. Only three case reports in children have been reported to date. The pathogenesis and treatment options are discussed and a method of managing this condition is suggested.
Subject(s)
Cysts/etiology , Emphysema/etiology , Tracheal Diseases/etiology , Tracheostomy/adverse effects , Adult , Cysts/diagnostic imaging , Emphysema/diagnostic imaging , Female , Humans , Tomography, X-Ray Computed , Tracheal Diseases/diagnostic imagingABSTRACT
Paediatric nasogastric tube placement can occasionally be difficult to perform. A unique case in a child is described where the tip of the nasogastric tube managed to travel via the Eustachian tube through the attic and into the mastoid cavity of the middle ear. To the best of the authors' knowledge, this has never been reported in the literature before.
Subject(s)
Ear Diseases/etiology , Eustachian Tube/injuries , Eustachian Tube/surgery , Iatrogenic Disease , Infant, Premature , Intubation, Gastrointestinal/adverse effects , Intubation, Gastrointestinal/instrumentation , Ear Diseases/diagnostic imaging , Follow-Up Studies , Humans , Infant, Newborn , Intubation, Gastrointestinal/methods , Radiography , Risk Assessment , Treatment OutcomeABSTRACT
While tonsillectomy is the commonest operation performed by otolaryngologists, paralysis of the hypoglossal nerve following tonsillectomy is not well recognized in the otolaryngology text or literature. We report a case of hypoglossal nerve paralysis following tonsillectomy and discuss the theories on the pathoaetiology as described in the predominantly anaesthetics literature. The likely causes of nerve injury are described and precautions are suggested to help avoid this problem.
