Air in retropharyngeal space

Case contributed by Thuan Tzen, Koh

Presentation

Difficulty breathing and dysphagia.

Patient Data

Age: 25 years
Gender: Male
x-ray

Thin air is seen within the retropharyngeal space and also tracks anteriorly along other neck fascial planes. No radiopaque foreign body such as a bone is identified within the soft tissues of the neck.  

Case Discussion

Air within the retropharyngeal space and tracking anteriorly along other neck fascial planes. The cause of the air leak may be a local perforation of the upper aerodigestive tract or the air may have tracked from the chest such as may be seen in pneumomediastinum related to asthma or with esophageal perforation. Clinical correlation and chest x-ray would be useful for further clarification. Contrast swallow under fluoroscopy could be used to exclude a pharyngeal or esophageal leak if required. 

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