A Case of Deep Cervical Abscess After Upper Gastrointestinal Endoscopy

Abstract

Patients with a deep cervical abscess sometimes show a serious course and require immediate surgical intervention. The main underlying causes if a deep cervical abscess are peritonsillar abscess, upper respiratory tract infection with acute tonsillitis, and dental infections; on the other hand, it can also, rarely, occur as a complication of medical procedures such as upper gastrointestinal endoscopic examination.

The risk of perforation associated with upper gastrointestinal endoscopic examination is estimated to be 0.004% to 0.007%.

While some cases of deep cervical abscess, especially those in which the condition is recognized early, can be cured by conservative treatment, others, especially those in which the condition is not detected sufficiently early, may require surgery.

We report a case of deep cervical abscess that occurred as a complication of upper gastrointestinal endoscopic examination.

The patient was a 71-year-old man, who complained of a boggy feeling in the right neck during upper gastrointestinal endoscopic examination, and then developed right neck pain and high fever (40C°) on the night of the examination. Since the symptoms did not improve, he visited our hospital on the 3rd day after the examination and was admitted. On the 3rd day of hospitalization, an emergency drainage was performed by external incision for a deep cervical abscess. In this case, the deep cervical abscess developed after upper gastrointestinal endoscopy and could be improved by external incision and drainage, but it was difficult to determine that the cervical abscess developed as a complication of perforation caused during gastrointestinal endoscopic examination.

It is important to determine the route of infection through history taking.