Thoracic complications of deeply situated serous neck infections.
Nine cases of complicated deep neck infections, occurring during a period of twelve years are presented. Complications observed were cervico-thoracic necrotizing fasciitis in 3 cases, purulent pleural effusion in 6 cases, pericardial effusion in 2, mediastinitis in 8 cases, jugular vein thrombosis and rupture of the innominate artery in one case each. Although 2 cases were managed initially with blind endotracheal intubation, all cases finally required tracheostomy. A cervico-mediastinal approach was useful for the early mediastinal involvement. Two patients died because of inadequacy of the multiple surgical procedures resulting in persistent infection and multi-organ failure and one because of uncontrollable bleeding after innominate artery rupture.
Colmenero Ruiz
C
C
Department of Maxillofacial Surgery, La Paz General Hospital Madrid, Spain.
Labajo
A D
AD
Yañez Vilas
I
I
Paniagua
J
J
D000293:Adolescent; D000328:Adult; D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery; D001424:Bacterial Infections / Q000150:complications*; D016122:Brachiocephalic Trunk; D004322:Drainage; D016724:Empyema, Pleural / Q000209:etiology* / Q000601:surgery; D005208:Fasciitis / Q000209:etiology; D005491:Focal Infection, Dental / Q000150:complications*; D006801:Humans; D008158:Ludwig's Angina / Q000209:etiology; D008297:Male; D008480:Mediastinitis / Q000209:etiology; D008875:Middle Aged; D009333:Neck; D009336:Necrosis; D010996:Pleural Effusion / Q000209:etiology; D011015:Pneumonia, Aspiration / Q000209:etiology; D012422:Rupture, Spontaneous; D013896:Thoracic Diseases / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D014139:Tracheostomy