Журнал клинических случаев

Severe Tracheal Dislocation Secondary to Neck Abscess, Successfully Treated by Urgent Percutaneous Drainage

Abstract

Othon P Michail, Emmanuel Pikoulis, Antonis Athanassiou, Paris Pappas and John Griniatsos

Abscesses and cellulitis represent the leading causes for emergency department visits and hospital admissions for intravenous drug addicts’ patients. Since these patients frequently use the neck for vascular access, neck abscesses are also commonly developed causing serious airway problems. A 28-year old Intravenous Drug Addict (IVDA) Caucasian male patient, presented to the casualty Department due to progressive neck swelling and pain after self-administered, unsterile, deep-cervical intravenous injection of heroin. Emergency contrast computed tomography scan revealed a large abscess causing significant dislocation of the trachea. The patient was urgently treated by percutaneous neck abscess drainage, via an 8Fr catheter, under ultrasound guidance Emergency computed tomography scan of the affected area and ultrasound scan of the major vascular supply are helpful in designing the therapeutic approach in terms of percutaneous drainage or surgery in cases of neck abscess that may cause airway obstruction in intravenous drug addicts. Percutaneous drainage under ultrasound guidance represents an effective treatment option relieving the life threatening trachea dislocation and eliminating the need for surgical intervention.