Retropharyngeal Abscess with a Missed Migrating Foreign Body: A Case Report

Retropharyngeal abscess is rare in adults that can lead to severe complications. We presented the case of a foreign patient developed a life-threatening retropharyngeal abscess, complicated with language barriers and a missed migrating chicken bone. A 42-year-old foreigner man with unknown comorbid presented with upper airway obstruction in a day, and neck swelling for 5 days. History taking was difficult due to a language barrier. The patient’s friend claims he experiencing sore throat, dysphagia and odynophagia for the preceding week. Examination showed biphasic stridor and diffused anterior neck swelling 5x5 cm, erythematous and warm. Flexible scope noted oedematous airway. Blood investigations showed sepsis. Patient intubated and urgent computed tomograpgy (CT) scan of the neck reported as extensive retropharyngeal collection. He underwent surgical drainage but the condition did not improve. Repeated CT scan revealed a migrating linear hyperdense foreign body at the C2/C3 level which was removed succesfully. Retropharyngeal abscess is a life-threatening condition with foreign body as a causative factor is uncommon in adults and can be challenging to detect, especially in the context of language barriers, thorough history taking, aided by imaging to locate the source of infection, led to the correct diagnosis and treatment.