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Foreign bodies with infection in the pharyngeal region have been commonly reported. But, there are only a few report about foreign bodies which reached to cervical spine and vertebral artery through retropharyngeal wall by stab injuries. A three-year-old girl, when sitting on a chair with the tip of a pencil in her mouth, was ridden on her head from behind by her younger brother. The pencil penetrated through retropharyngeal space, and the tip of it reached to the left vertebral artery of C2/3 level. She had a high temperature over 40°C in four days. She was admitted to our hospital on the seventh day after injury. It was difficult to find the non-radiopaque fragments, in the plain X-rays. But a CT scan showed such foreign bodies, and also demonstrated their relationship to soft tissues around them giving us many informations about site, size and shape of them. The removal of it was immediately performed by anterior approach under general anesthesia. She has had good clinical course after operation and now, she has no problems.

A unusual case of stab wound by a pencil in the pharyngeal region injurying vertebral artery.