Acute Mediastinitis
Mediastinitis aguda
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Ninguna publicación, nacional o extranjera, podrá reproducir ni traducir sus artículos ni sus resúmenes sin previa autorización escrita del editor; sin embargo los usuarios pueden descargar la información contenida en ella, pero deben darle atribución o reconocimiento de propiedad intelectual, deben usarlo tal como está, sin derivación alguna.
Show authors biography
Background. Acute mediastinitis is one of the most aggressive chest diseases. The mortality rate ranges between 14% and 42%.
Objectives. A Descriptive Analysis of a Series of Patients Diagnosed With Acute Mediastinitis
Design. Descriptive retrospective study cohort university hospital.
Patients- Methods. We present a analysis of a series of 52 cases (40 men and 12 women) treated between January 1984 and March 2004 and review the literature.
Results. Mediastinitis originated in the esophagus in 34 patients (16 postoperative, 10 due to iatrogenic perforation, 6 due to noniatrogenic perforation, and 2 due to a foreign body) and in the oropharynx in 12 patients; mediastinitis was secondary to median sternotomy in 6. 52 patients were treated surgically. In addition to radical debridement and drainage, which were carried out on all the patients, 31 also underwent esophagectomy and esophagogastric reconstruction, 16 received primary sutures of the esophagus, 3 received reconstructive surgery with a pectoral muscle flap, and 2 underwent sternectomy plus intrathoracic omental transposition. Two patients died within 30 days of surgery. The mortality rate in our practice is lower to that described in the literature (3,84%).
Conclusions. The results argue for early, aggressive treatment.
Article visits 240 | PDF visits 186
Downloads
- Estrera AS, Lanay MJ, Grisham JM, et al. Descending cervical mediastinitis. Surg Gynecol Obstet 1983;157:545-52.
- González-Aragoneses F, Moreno-Mata N, Orusco -Palomino E, et al. Mediastinitis descendente necrosante de origen orofaríngeo. Arch Bronconeumol 1996;32:394-6.
- Cherveniakov A, Cherveniakov P. Surgical treatment of acute purulent mediastinitis. Eur J Cardiothorac Surg 1992;6:407-11.
- Melero-Sancho LM, Minamoto H, Fernández A, et al. Descending necrotizing mediastinitis: a retrospective surgical experience. Eur J Cardiothorac Surg 1999;16:200-5.
- Marty-Ané CH, Berthet JP, Alric P, et al. Management of descending necrotizing mediastinitis: an aggressive treatment for an aggressive disease. Ann Thorac Surg 1999;68:212-7.
- Papalia E, Rena O, Oliaro A, et al. Descending necrotizing mediastinitis: surgical management. Eur J Cardiothorac Surg 2001;20:739-42.
- Dwivedi MK, Pal RK, Gupta R, et al. CT finding of descending necrotizing mediastinitis. Ind J Radiol Imag 2001;11/3:131-4.
- De Feo M, Gregorio R, Della Corte A, et al. Deep sternal wound infection: the role of early debridement surgery. Eur J Cardiothorac Surg 2001;19: 811-6.
- Bladergroen MR, Lowe JE, Postlethwait RW, et al. Diagnosis and recommended management of aesophageal perforation and rupture. Ann Thorac Surg 1986;42:235-9.
- Lyons WL, Seremetis MG, DeCuzman VC, et al. Ruptures and perforations of the esophagus: the case for conservative supportive management. Ann Thorac Surg 1978;25:346-50.
- Luc M, Grillo HC, Malt RA. Esophageal perforation. Ann Thorac Surg 1982;32:203-10.
- Merkle NM, Foitziik TH, Riedl S, et al. Infektionen des Mediastinums. Chirurg 1990;61:629-38.
- Moghissi K, Pender D. Instrumental perforations of the oesophagus and their management. Thorax 1988;43:641-6.
- Brewer LA, Carter R, Mulder GA, et al. Options in the management of perforations of the esophagus. Am J Surg 1986; 152:62-9.
- Marty-Ané CH, Alric P, Alauzen M. Descending necrotizing mediastinitis. Advantage of mediastinal drainage with thoracothomy. J Thoracic Cardiovasc Surg 1994;107:55-61.
- Gabor et al. Indications for surgery in traqueobronquial ruptures. Eur J Cardiothorac Surg 2001;20:399-404.
- Schroeyers P, Wellens F, Degrieck I, et al. Aggressive primary treatment for poststernotomy acute mediastinitis: our experience with omental and muscle flap surgery. Eur J Cardiothorac Surg 2001;20:743-6.
- Wheatlhy CH, Stirling MC, Kilsh MM. Descending necrotizing mediastinitis. Trans-cervical drainage is not enough. Ann Thorac Surg 1990;49:780-4.
- El Oakley RM, Wright JE. Postoperative mediastinitis: classification and management. Ann Thorac Surg 1996;61:1030-6.
- Berg HF, Brands WGB, Van Geldorp TR, et al. Comparison between closed drainage techniques for the treatment of postoperative mediastinitis. Ann Thorac Surg 2000;70:924-9.
- Cherveniakov A, Cherveniakov P. Surgical treatment of acute purulent mediastinitis. Eur J Cardiothorac Surg 1992;6:407-11.
Information
Journal history
Keywords
QR code
Funding
Directories and indexes
