金属製スプーンによる中咽頭外傷で生じた縦隔気腫例

Children often fall down while holding an object in the oral cavity which often results in puncture laceration injuries of the oral cavity or oropharynx. We report herein on a case of oropharyngeal trauma with mediastinal emphysema caused by a metal spoon. A 3-year-old girl fell down while holding a metal spoon in her mouth, and sustained an injury to her oral cavity. She bled from the mouth and visited an emergency room on the day of the injury. At the time of examination, bleeding from oropharyngeal trauma was stopped. CT revealed emphysema in the neck, otherwise the physical exam was normal, so she was prescribed a preventive oral antibiotic and her mother was instructed regarding home treatment. The girl developed a fever the next day, and CT showed enlargement of the emphysema to the upper mediastinum. She was admitted to a referral hospital, stopped oral intake, and received antibiotic infusion. She was referred to our hospital on the third day of the injury because the fever continued. She was maintained on the conservative treatment, and was discharged without any serious complication on the seventh post-injury day. In similar accident, some cases have been reported with complications such as respiratory failure due to mediastinal emphysema, abscess formation, and internal carotid artery obstruction. Appropriate diagnosis and watchful observation are important.