[A Descriptive Analysis of a Series of Patients Diagnosed With Acute Mediastinitis]

Arch Bronconeumol. 2003 Sep;39(9):428-30. doi: 10.1016/s0300-2896(03)75419-2.
[Article in Spanish]

Abstract

Acute mediastinitis is one of the most aggressive chest diseases. The mortality rate ranges between 14% and 42%. We present a retrospective analysis of a series of 26 cases (20 men and 6 women) treated between January 1994 and March 2002 and review the literature. Mediastinitis originated in the esophagus in 17 patients (8 postoperative, 4 due to iatrogenic perforation, 4 due to noniatrogenic perforation, and 1 due to a foreign body) and in the oropharynx in 6 patients; mediastinitis was secondary to median sternotomy in 3. Twenty-five patients were treated surgically. In addition to radical debridement and drainage, which were carried out on all the patients, 10 also underwent esophagectomy or resection of the esophago-gastric reconstruction, 5 received primary sutures of the esophagus, 1 received reconstructive surgery with a pectoral muscle flap, and 1 underwent sternectomy plus intrathoracic omental transposition. Four patients died within 30 days of surgery (15.4%). The mortality rate in our practice is similar to that described in the literature. The results argue for early, aggressive treatment.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Drainage / methods
  • Female
  • Humans
  • Male
  • Mediastinitis / complications*
  • Mediastinitis / diagnosis
  • Mediastinitis / therapy*
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies