Descending necrotizing mediastinitis: Evaluation of 30 cases

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dc.authorid0000-0001-5778-385Xen_US
dc.authorid0000-0001-7533-9402en_US
dc.authorid0000-0003-1490-1865en_US
dc.authorid0000-0003-0498-4935en_US
dc.contributor.authorOruç, Menduh
dc.contributor.authorOruç, Kamile
dc.contributor.authorMeteroǧlu, Fatih
dc.contributor.authorŞahin, Atalay
dc.date.accessioned2023-12-21T06:31:06Z
dc.date.available2023-12-21T06:31:06Z
dc.date.issued2023en_US
dc.departmentDicle Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Göğüs Cerrahisi Ana Bilim Dalıen_US
dc.description.abstractMediastinitis 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.en_US
dc.identifier.citationOruç, M., Oruç, K., Meteroğlu, F. ve Şahin, A. (2023).Descending necrotizing mediastinitis: Evaluation of 30 cases. Indian Journal of Surgery, 85, 465-470.en_US
dc.identifier.doi10.1007/s12262-022-03651-6
dc.identifier.endpage470en_US
dc.identifier.issn0972-2068
dc.identifier.scopus2-s2.0-85145036920
dc.identifier.scopusqualityQ4
dc.identifier.startpage465en_US
dc.identifier.urihttps://link.springer.com/article/10.1007/s12262-022-03651-6
dc.identifier.urihttps://hdl.handle.net/11468/13103
dc.identifier.volume85en_US
dc.identifier.wosWOS:000905848600001
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.institutionauthorOruç, Menduh
dc.institutionauthorOruç, Kamile
dc.institutionauthorMeteroğlu, Fatih
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.relation.ispartofIndian Journal of Surgery
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectDescendingen_US
dc.subjectInfectionen_US
dc.subjectMediastinitisen_US
dc.subjectNecrotizingen_US
dc.titleDescending necrotizing mediastinitis: Evaluation of 30 casesen_US
dc.titleDescending necrotizing mediastinitis: Evaluation of 30 cases
dc.typeArticleen_US

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