Impacted Pen Cap in Pharynx Leading to Pharyngojugular and Pharyngocutaneous Fistula in an Infant

Namita Ravikumar; Puspraj Awasthi; Karthi Nallasamy; Suresh Kumar Angurana; Muralidharan Jayashree

doi:10.1055/s-0040-1701208

Journal of Pediatric Intensive Care, Table of Contents

J Pediatr Intensive Care 2020; 09(03): 218-221
DOI: 10.1055/s-0040-1701208

Case Report

Georg Thieme Verlag KG Stuttgart · New York

Impacted Pen Cap in Pharynx Leading to Pharyngojugular and Pharyngocutaneous Fistula in an Infant

Authors

Namita Ravikumar

¹Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Puspraj Awasthi

¹Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Karthi Nallasamy

¹Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Suresh Kumar Angurana

¹Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Muralidharan Jayashree

¹Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

Abstract

Foreign body-related injuries to aerodigestive tract and large neck vessels are rare but can be catastrophic if not identified and treated in time. We report an infant with impacted foreign body (pen cap) in the pharynx which went unnoticed until it led to the formation of a fistula with the internal jugular vein (IJV) and massive hemorrhage. His course was complicated by ventilator-associated pneumonia, air leaks, shock, acute kidney injury, prolonged mechanical ventilation, and pharyngocutaneous fistula. The surgical removal of foreign body, ligation of IJV, closure of pharyngeal defect, and supportive treatment in pediatric intensive care unit led to a favorable outcome. This is the first case of pharyngojugular and pharyngocutaneous fistula following an impacted foreign body in the pharynx.

Keywords

foreign body - pharyngojugular fistula - pen cap

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References

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