Hassan Nouri

Retropharyngeal abscess revealing a migrant foreign body complicated by mediastinitis: a case report

Pharyngeal foreign bodies are quite common. Their diagnosis is usually easy. The risk of complications including retropharyngeal abscess and mediastinitis is rare and it depends mainly on the nature of the foreign body and the period of the therapeutic management. The occurrence of these complications darkens the prognosis of this affection usually benign. We report a 21 years old patient, without any significant history, admitted to the emergency for a high painful dysphagia and impaired general condition with fever 20 days after trauma in the posterior pharyngeal wall following a meal. The radiological assessment including cervico-thoracic CT scan had objectified the presence of a metallic foreign body in the retropharyngeal space associated with a retropharyngeal abscess and aggravated by a mediastinitis following the migration of the foreign body to the chest. Biological markers of infection were very increased. The therapeutic management consisted of a surgical drainage of the collections by a cervicotomy with removal of the foreign body. The outcome was favorable clinically and biologically. Pharyngeal foreign bodies are common and favorable when the diagnosis and extraction are made on time. The occurrence of complications, especially retropharyngeal abscess and mediastinitis is rare and burdened with a high morbidity and mortality.

Hémangiome capillaire caverneux du septum nasal

INTRODUCTION Hemangioma are rare benign vascular tumors. Histologically, there are several types including capillary, cavernous and mixed hemangioma. We present a very rare mixed hemangioma of the nasal septum. CASE REPORT A 30-year-old woman consulted for unilateral epistaxis and nasal obstruction. CT scan revealed a tumor filling the rhinopharynx, strongly enhanced after injection of contrast medium. It was pedicled on the posterior and superior nasal septum. Arteriography revealed a vascular blush. Tumor exeresis was performed by paralateronasal approach and endoscopic surgery. The histological examination identified a mixed hemangioma. DISCUSSION Capillary and cavernous hemangiomas are rare and benign vascular tumors developing in the skin and subcutaneous tissues of the head and neck, and/or oral and nasal mucosa. No mixed hemangioma exclusively involving the nasal septum had been previously reported. Complete surgical resection is the treatment of choice, providing a favorable prognosis with low risk of recurrence.