Mediastinal abscess caused by a pyriform sinus fistula: report of a case.

A 13-year-old boy who originally presented with a left neck abscess rapidly developed a mediastinal abscess and empyema. Repetitive esophagography for the persistent mediastinal abscess revealed the existence of a pyriform sinus fistula. It was thought that infection of the pyriform sinus fistula precipitated a retropharyngeal abscess which continuously extended to the mediastinum. To our knowledge, no other such case has ever been reported and we present this unusual case herein, followed by a short review of the related literature.