Abstract
A case of pyriform sinus fistula which was not diagnosed by repeated barium meal and finally done by sinogram which was taken by using a rigid bronchoscope is presented.
An eighteen-year-old female had a recurrent suppurative infection (five times) on the left anterior neck since seven years of age and received drainage every time. At fifteen years old when after she had the third infection, radical operation for a lateral cervical cyst was performed. After the fourth infection, pyriform sinus fistula was strongly suspected and barium meal was performed three times when she has no infection. But the fistula had never been opacified. So a new technique using the rigid bronchoscope and X-ray imaging system was tried. After confirmation of the entrance of the pyriform recess by the rigid bronchoscope, a fine tube (5 Fr) was inserted into the apex of the pyriform recess, and contrast media was injected under the X-ray image. A fistula arising from the pyriform recess was successfully visualized. The use of rigid bronchoscope and tube was also useful in detection of the fistula at operation.
