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Retropharyngeal abscess (RPA) is an abscess located in the tissues in the back of the throat behind the posterior pharyngeal wall (the retropharyngeal space).Because RPAs typically occur in deep tissue, they are difficult to diagnose by physical examination alone.
The investigation of choice is imaging of retropharyngeal space with magnetic resonance imaging (MRI), specifically looking for tumour or infection. [ 1 ] [ 2 ] [ 3 ] Syndrome was described first by Maurice Villaret (1877 – 1946), a French neurologist.
Superiorly, the retropharyngeal space terminates at the base of the skull (more specifically, at the clivus [2]). [1] [5] Inferiorly, the true RPS terminates at a variable level along the upper thoracic spine with the fusion of alar fascia and visceral fascia; [1] sources either give the inferior termination of the true RPS as occurring at approximately the vertebral level of T4 [2] or at a ...
The retropharyngeal lymph nodes, from one to three in number, lie in the buccopharyngeal fascia, behind the upper part of the pharynx and in front of the arch of the atlas, being separated, however, from the latter by the longus capitis. Their afferents drain the nasal cavities, the nasal part of the pharynx, and the auditory tubes.
The condition is characterised by chronic gastrointestinal symptoms relating to excessive gas retention including abdominal bloating with distension, flatulence, audible gurgling sounds, and chest and abdominal discomfort. [2] Some with the condition are also unable to vomit, or can only do so with great difficulty.
As the symptoms of streptococcal pharyngitis overlap with other conditions, it can be difficult to make the diagnosis clinically. [13] Coughing, nasal discharge, diarrhea, and red, irritated eyes in addition to fever and sore throat are more indicative of a viral sore throat than of strep throat. [13]
The condition often follows soft tissue inflammation in the neck such as in cases of upper respiratory tract infections, peritonsillar or retropharyngeal abscesses. Post-operative inflammation after certain procedures such as adenoidectomy can also lead to this condition in susceptible individuals such as those with Down syndrome.
At the base of this recess is the retropharyngeal lymph node (the node of Rouvière). This is clinically significant in that it may be involved in certain head and neck cancers , notably nasopharyngeal cancer .