Favorable results of early diagnosis by cervicothoracic computed tomography scans for descending necrotizing mediastinitis.
OBJECTIVE
We studied results of early diagnosis by cervicothoracic computed tomography and early aggressive surgery for descending necrotizing mediastinitis.


METHODS
Between 1990 and 1999, 5 patients with descending necrotizing mediastinitis were surgically treated in our institute. Computed tomography scans confirmed mediastinitis in all cases, even though chest x-ray films demonstrated a widening mediastial shadow in only 2. Soon after surgical drainage of the deep neck infection and diagnosis of descending necrotizing mediastinitis, all patients underwent surgical mediastinal drainage. Mediastinitis was drained by thoracotomy in 1, managed thoracoscopically in 1 and cervicomediastinally drained in 3.


RESULTS
The outcome was favorable in all patients.


CONCLUSIONS
Early diagnosis by cervicothoracic computed tomography and early aggressive surgery for descending necrotizing mediastinitis are essential to favorable outcome.
Takanami
I
I
Department of Surgery, Teikyo School of Medicine, 2-2-11 Kaga, Itabashi-Ku, Tokyo 173-0003, Japan.
Takeuchi
K
K
D000328:Adult; D000368:Aged; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D008482:Mediastinum / Q000473:pathology; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging; D009336:Necrosis; D010608:Pharyngeal Diseases / Q000473:pathology; D012189:Retrospective Studies; D013906:Thoracoscopy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome