[Descending necrotizing mediastinitis].
We estimated reliability of computed tomography scan for early detection of mediastinal infectious inflammation, influence of descending necrotizing mediastinitis type and extent of urgent surgical intervention on final treatment results. A retrospective analysis was completed with clinical experience, involving 19 patients (11 male, 8 female), 38-78 years of age, operated on due to descending necrotizing mediastinitis in 1992-2002. Early diagnosis, using computed tomography scan, and more aggressive surgical management allowed to decrease mortality rate from 85.7 % ( in 1992-1998) to 50.0 % (in 1999-2002). We suggest an algorythm for well-timed diagnosis and complex surgical treatment of descending necrotizing mediastinitis based on results of this study and medical literature review.
Rubikas
Romaldas
R
Clinic of Thoracic Surgery, Kaunas University of Medicine Hospital, Eiveniu 2, 3007 Kaunas, Lithuania.
Gradauskas
Paulius
P
Vilcinskas
Algirdas
A
Petrauskas
Valdas
V
Samiatina
Diana
D
Krasauskas
Arnoldas
A
D000038:Abscess / Q000150:complications*; D000328:Adult; D000368:Aged; D000465:Algorithms; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery; D008875:Middle Aged; D009336:Necrosis; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed