Descending necrotising mediastinitis – surgical management
Authors:
J. Šafránek 1; V. Špidlen 1; T. Skalický 1; J. Vodička 1; J. Martínek 2; P. Andrle 3
Authors‘ workplace:
Chirurgická klinika FN Plzeň, přednosta: prof. MUDr. V. Třeška, DrSc.
1; Otorinolaryngologická klinika FN Plzeň, přednosta: Doc. MUDr. J. Slípka, CSc.
2; Stomatologická klinika FN Plzeň, přednosta: Doc. MUDr. A. Zicha, CSc.
3
Published in:
Rozhl. Chir., 2012, roč. 91, č. 7, s. 362-367.
Category:
Original articles
Overview
Introduction:
Descending necrotising mediastinitis (DNM) is a less common form of infection in the mediastinum caused by downward spread from the cervical, oral and pharyngeal regions.
Material and methods:
We retrospectively evaluate a group of patients who underwent surgical management of DNM at our department between 2007 and 2011.
Results:
We operated on 7 patients (1 female, 6 males) with the mean age of 56.3 years. In 3 cases the infection was of odontogenic origin and in 4 cases of tonsillar origin. Except for one patient with permanent immunosuppression, after kidney transplantation, swab culture showed the original, inciting pathogen to be Streptococcus in all cases; as for anaerobic organisms it was mostly Fusobacterium. In all cases we performed external cervical drainage and mediastinal drainage through a cervical approach. In 3 cases it was necessary to perform mediastinal drainage through thoracotomy. Mean hospital stay was 45.7 days, 30-day mortality was zero.
Conclusion:
The results confirm a better prognosis of DNM compared to mediastinitis caused by oesophageal perforation or oesophageal surgery complication.
Key words:
mediastinitis – odontogenic infection – peritonsillar abscess
Sources
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Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2012 Issue 7
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