Caustic Ingestion
Caustic ingestion causes chemical injury to the upper gastrointestinal tract. It most commonly affects the oesophagus (alkali) and stomach (acid). 80% occur in children. It has a high morbidity and mortality. The severity of corrosive burns to the oesophagus depends on:…
Foreign Body Ingestion
The most common non-food objects ingested in children are coins. In adults, the most common objects are fish bones, dentures, and meat.
Lymphadenopathy
Lymphadenopathy is defined as a lymph node that is greater than 1 cm in diameter. Most cases of lymphadenopathy are related to infections: these resolve independently or after antibiotic treatment. Lymph node sites Lymph node site Area drained Cervical Head and…
Laryngopharyngeal Reflux
Laryngopharyngeal reflux (LPR), also known as the silent reflux (no belching or vomiting), is the retrograde flow of gastric contents into the nasopharynx, oropharynx, or laryngopharynx. The effect of gastric acid on the larynx and pharynx causes an inflammatory response, which…
Cervicofacial Necrotizing Fasciitis
Cervicofacial necrotizing fasciitis (CNF) is an aggressive polymicrobial infection of the subcutaneous tissue and fascia of the face and neck. It is characterized by local ischemia (due to vascular thrombosis), which leads to necrosis and ulceration of the skin and soft tissue. Myonecrosis can…
Ludwig’s Angina
Ludwig’s angina is a bilateral cellulitis involving the submandibular, submental, or sublingual spaces. The three characteristics of Ludwig’s angina can be remembered as the three F’s – Feared, Fatal, and rarely fluctuant. The most serious complications that make the condition rapidly fatal are airway obstruction due…
Peritonsillar Abscess
A peritonsillar abscess is the collection of pus in the tissue surrounding the tonsils: between the glossopalatine and pterygopalatine muscles, which are surrounded by a capsule. It is a serious complication of tonsillitis. It peaks between 30 and 40 years of age.
Retropharyngeal Abscess
A retropharyngeal abscess is a collection of pus in the retropharyngeal space. It is caused by infected lymphatic drainage, or contiguous spread from a URTI or oral infection. It commonly affects children < 5 years old.
Neck Infections
Neck infections can be broadly divided into superficial and deep infections. Classification of Neck Infections Category Examples Necrotizing Impetigo, erysipelas, cellulitis (Ludwig’s angina), lymphadenititis, and subcutaneous abscesses Necrotizing superficial neck infections Cervicofascial necrotizing fasciitis and purpura fulminans Deep neck infections Parapharyngeal abscess, retropharyngeal…