Primary Repair of Traumatic Hypopharyngeal Perforation via Transcervical Endoscopic Approach in an Infant.

An 11-month-old female presented with respiratory distress, neck swelling, and sepsis following the manual removal of a foreign body (a broken Shivling) from her throat. Imaging revealed pneumo-retropharynx and a large retropharyngeal abscess. After initial stabilization and resuscitation, transcervical endoscopy was employed to drain the abscess and repair a mucosal tear in the left pyriform sinus. The patient recovered well, with no postoperative complications and complete healing confirmed via endoscopy and esophagogram. This case highlights an innovative endoscopic approach, which enabled precise visualization and suturing of the hypopharyngeal perforation while avoiding extensive neck dissection, large cervical scars, and associated morbidity.