Severe sore throat (more often on one side), inability to swallow, fever, weakness, and enlarged cervical lymph nodes may be symptoms of a paratonsillar abscess. At the same time, purulent inflammation forms next to the palatine tonsil. Most often, an abscess is a complication of angina and develops a few days after recovery. This is a very serious disease that requires surgical treatment. Improper treatment can lead to the development of life-threatening complications.
The patient was admitted to our clinic in serious condition on the third day of his illness. He has two abscesses formed on one side. This phenomenon is very rare (only a few cases have been described). The situation was aggravated by concomitant diseases: coronary heart disease, hypertension, diabetes mellitus.
Considering these circumstances, a large amount of research was required before the operation: consultations with a therapist and a cardiologist, echo cardiography, laboratory tests. All studies were conducted in an emergency mode.
A mandatory stage in the diagnosis of paratonsillar abscesses is computed tomography (CT) with contrast. The CT scan revealed the presence of not one, but two abscesses. At the same time, the second abscess turned out to be small in size and was located in an area where it is almost impossible to open the abscess using a routine procedure. The information obtained on CT allowed us to correctly determine the scope of the operation, in which the abscess is opened simultaneously with the removal of the tonsil (abscess tonsillectomy).
3 hours after the treatment, the patient was admitted to the operating room. The operation was performed under general anesthesia and was successful – the very next day his health improved.
The hospitalization lasted 3 days, during which, in addition to treating the underlying disease, the patient underwent an extended examination. A plan for further follow-up and treatment was formed, and the treatment of hypertension, coronary heart disease, and diabetes mellitus was adjusted.
This case demonstrates the capabilities of the EMC to solve the most complex diagnostic and therapeutic tasks 24/7. A full-fledged examination at the preoperative stage, the optimal amount of surgery, and an interdisciplinary approach in the postoperative period made it possible to achieve a rapid recovery of the patient, avoid complications, and reduce the time of hospitalization and disability.