Differential Diagnosis for a Pediatric Patient with Throat Trauma and Difficulty Swallowing

• Single most likely diagnosis:
  • Traumatic laryngitis or bruising of the larynx: This is the most likely diagnosis given the mechanism of injury (being hit in the throat with a soccer ball) and the symptom of difficulty swallowing. The force of the impact could cause inflammation or bruising to the larynx, leading to pain and discomfort when swallowing.
• Other Likely diagnoses:
  • Pharyngeal or esophageal bruising or hematoma: Similar to laryngeal bruising, the force of the soccer ball could also cause bruising or hematoma in the pharynx or esophagus, leading to difficulty swallowing due to pain or obstruction.
  • Soft tissue injury (e.g., neck sprain or strain): The impact could result in injury to the soft tissues of the neck, including muscles and ligaments, which might cause pain and stiffness, potentially contributing to difficulty swallowing.
• Do Not Miss diagnoses:
  • Airway obstruction or compromise: Although less likely, it is crucial not to miss a potential airway obstruction due to severe swelling, hematoma, or fracture of the larynx or trachea, as this could be life-threatening.
  • Esophageal perforation: A rare but serious condition where the esophagus is perforated, potentially leading to infection, abscess, or mediastinitis. This would require immediate medical attention.
  • Laryngeal fracture: A fracture of the laryngeal cartilages could occur from significant trauma, leading to severe respiratory distress or difficulty swallowing.
• Rare diagnoses:
  • Thyroid or cricoid cartilage fracture: While possible, fractures of these specific cartilages are less common and would typically be associated with more severe trauma.
  • Retropharyngeal hematoma or abscess: These conditions could arise from trauma but are less common and might present with difficulty swallowing among other symptoms like neck stiffness or fever.
  • Vocal cord paralysis or injury: Direct injury to the vocal cords could result from the trauma, leading to hoarseness, breathiness, or difficulty swallowing, though this is less likely compared to other diagnoses.