[Surgical treatment for patients with descending necrotizing mediastinitis].
Descending necrotizing mediastinitis (DNM) originating from deep cervical infection is a rare and serious clinical condition with a high mortality rate. Clinical feature of 5 patients undergone surgical drainage for DNM, between 2006 and 2009 were assessed. There were 3 male and 2 female patients whose age ranged from 57 to 83 years old (mean 69.8). All 5 patients had no underlying disease except for 1 patient with severe dental caries. The primary infections of these patients were tonsillitis and pharyngitis. The mean duration from onset of symptom to the referral to our hospital was 14 days (ranged 2 to approximately 41). Two patients underwent cervical drainage for upper mediastinum, and 3 patients were required mediastinal drainage by thoracotomy. There was no post-operative death. Early and aggressive surgical drainage of the neck and mediastinum by a multidisciplinary team of surgeons is very important in the treatment of DNM.
Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu, Japan.
S
S
Oka
T
T
Hanagiri
M
M
Takenaka
T
T
Baba
M
M
Yasuda
K
K
Ono
H
H
Uramoto
M
M
Takenoyama
K
K
Yasumoto
D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D010612:Pharyngitis / Q000150:complications; D014069:Tonsillitis / Q000150:complications