Descending necrotizing mediastinitis: Evaluation of 30 cases
Yükleniyor...
Tarih
2023
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Springer
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Mediastinitis is an infammation of the mediastinum. Descending necrotizing mediastinitis (DNM) is the most common form
of mediastinitis. Symptoms of severe oropharyngeal infection, radiological evidence of mediastinitis, documentation of necrotising mediastinitis at surgery, and a relationship between the infection and a necrotizing process are all diagnostic criteria.
The worsening conditions of fever, neck and chest pain, and respiratory distress are presenting features. Without aggressive
surgical drainage, DNM may become fatal. Early diagnosis and prompt therapy play a crucial role in the management of
mediastinitis. We aimed to compare the clinical features of mediastinitis. DNM cases that were treated in our clinics in the
last 10 years were retrospectively reviewed. Patients with DNM were divided into three groups according to tomographic
images. Demographic characteristics, accompanying diseases, anatomical localization, medical and surgical management,
other clinical features, and morbidity and mortality rates of patients were collected and compared with univariate analysis.
The adequacy of neck exploration or the need for additional surgery was determined by preoperative and postoperative
computerized tomography evaluation. The etiologic causes of DNM were oropharyngeal in 12 cases and dental in 18 cases.
The mean age of the 19 men and 11 women was 37 years. Mediastinal localization according to a computerized tomography
image was type I in 11 patients, type IIA in 6 patients, and type IIB in 13 patients. The most common accompanying disorders
were diabetes mellitus in 16.6%, cardiac disease in 10.0%, and hepatic in 3.3%. Neck exploration was performed in almost
all cases. When the physicians failed to manage the patient with a single neck exploration procedure, mediastinoscopy, tube
thoracostomy, and thoracotomy were added. In the series, 7/30 (23%) patients died. The mean duration of an intensive care
unit stay was 29 days. Bacterial growth was cultured in 14 patients including all nonsurvivors. Because the prognosis is poor
and the disease is more likely to spread below the carina in delayed cases, regardless of the aetiology or type of mediastinitis,
aggressive surgery should be performed immediately.
Açıklama
Anahtar Kelimeler
Descending, Infection, Mediastinitis, Necrotizing
Kaynak
Indian Journal of Surgery
WoS Q Değeri
Q4
Scopus Q Değeri
Q4
Cilt
85
Sayı
Künye
Oruç, M., Oruç, K., Meteroğlu, F. ve Şahin, A. (2023).Descending necrotizing mediastinitis: Evaluation of 30 cases. Indian Journal of Surgery, 85, 465-470.
