[Descending necrotizing mediastinitis].
BACKGROUND
[corrected] Descending necrotizing mediastinitis (DNM) is an acute, serious, septic disease which results from a complication of oropharyngeal infection. The disease requires a prompt diagnosis and radical surgical treatment to reduce high mortality (40%). The optimal form of mediastinal drainage remains conroversial. The reason for publishing this report is both the fact that DNM is very rare and our experience prefering thoracotomy as an optimal approach to treating the disease.


METHODS
We reported a 34-years-old woman with DNM. The disease began as a peritonsillar abscess. After a bilateral double pleural drainage the disease worsened. In order to achieve radical mediastinal debridement and drainage, we carried out posterolateral right thoracotomy. We also had to perform left thoracotomy bacause of massive bleeding coused by septic erosion. There were no more reoperations.


CONCLUSIONS
Aggressive surgical treatment, regardless the localization and the extent of changes is the key to success in the treatment of patients with necrotizing mediastinitis.
Cvijanović
Vlado
V
Vojnomedicinska akademija, Klinika za grudnu hirurgiju, Beograd. petun@yubc.net
Stanić
Vojkan
V
Ristanović
Aleksandar
A
Gulić
Bojan
B
Durković
Savo
S
Stamenović
Davor
D
Marić
Nebojsa
N
D006801:Humans; D008480:Mediastinitis / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D009336:Necrosis; D000039:Peritonsillar Abscess / Q000150:complications