Korean J Crit Care Med.  2013 Aug;28(3):214-217. 10.4266/kjccm.2013.28.3.214.

Pyriform Sinus Perforation in a Child after Falling with a Spoon Handle in the Mouth

• Cho J
• Park MR
• Kim J
• Jeong HS
• Ahn K

• KMID: 2227844
• DOI: http://doi.org/10.4266/kjccm.2013.28.3.214

Abstract

Pyriform sinus perforation is uncommon in children and most cases are secondary to iatrogenic causes such as endotracheal intubations. Due to this rarity, the management of these injuries is controversial. We report a case of pyriform sinus perforation in a 14-month-old boy who fell down with a spoon handle in the mouth and was successfully treated by transoral laryngomicrosurgery. Two hours after falling down, the patient had breathing difficulties and started vomiting. A chest X-ray showed subcutaneous emphysema and pneumomediastium. Esophagogram revealed leakage of contrast media at the hypopharynx. Although air leakage was reduced the next day, his fever became frequent even with conservative management of antibiotics. On the 4th hospital day, closure of pyriform sinus perforation was done by transoral laryngomicrosurgery. The patient became apyrexial by the 2nd post-operative day. On the 21th hospital day, the child was able to consume food orally without problems and was allowed to go home.

Keyword

child; hypopharynx; injury; perforation; pyriform sinus

MeSH Terms

Anti-Bacterial Agents
Child
Contrast Media
Fever
Humans
Hypopharynx
Intubation, Intratracheal
Mouth
Pyriform Sinus
Respiration
Subcutaneous Emphysema
Thorax
Vomiting
Anti-Bacterial Agents
Contrast Media