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Korean J Crit Care Med > Volume 28(3); 2013 > Article
Korean Journal of Critical Care Medicine 2013;28(3): 214-217. doi: https://doi.org/10.4266/kjccm.2013.28.3.214
수저를 입에 물고 넘어진 소아에서 발생한 이상와 천공
조중범ㆍ박미란*ㆍ김지현*ㆍ정한신†ㆍ안강모*
성균관대학교 의과대학 삼성서울병원 중환자의학과, *소아청소년과, †이비인후과
Pyriform Sinus Perforation in a Child after Falling with a Spoon Handle in the Mouth
Joongbum Cho, Mi Ran Park, Jihyun Kim, Han Sin Jeong, Kangmo Ahn
1Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
2Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kmaped@skku.edu
3Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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.
Key Words: child; hypopharynx; injury; perforation; pyriform sinus
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