Minimally invasive drainage of a giant retropharyngeal abscess

SummaryObjective: To report a case of a 17-month-old female presenting with a giant retropharyngeal abscess and to outline the minimally invasive technique that was used to drain it. Design: Case study. Results: A previously healthy 17-month-old female was found by contrast-enhanced computed tomography (CECT) to have a retropharyngeal abscess (RPA) which extended from the level of the nasopharynx to the level of the aortic arch. The RPA measured 4.5 cm transversely, 2.7 cm antero-posteriorly and 8.0 cm cephalocaudally. After orotracheal intubation, transoral incision and drainage of the abscess was performed. Based on the CECT findings, the baby Yankauer suction was advanced 6 cm beyond the oropharyngeal incision (within the retropharynx) to break the distal septae and completely drain the RPA with a minimally invasive technique. Discussion: Our case describes the management of the largest RPA in the medical literature. We present the first report of the use of a baby Yankauer suction advanced through the oropharyngeal incision to drain intrathoracic RPA loculations.