[A descriptive analysis of a series of patients diagnosed with acute mediastinitis].
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.
Macrí
P
P
Sección de Cirugía Torácica. Hospital Universitario de Salamanca. Salamanca. España. paolomacri@katamail.com
Jiménez
M F
MF
Novoa
N
N
Varela
G
G
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies
Análisis descriptivo de una serie de casos diagnosticados de mediastinitis aguda.