[Descending necrotising mediastinitis - surgical management].
BACKGROUND
Descending necrotising mediastinitis (DNM) is a less common form of infection in the mediastinum caused by downward spread from the cervical, oral and pharyngeal regions.


METHODS
We retrospectively evaluate a group of patients who underwent surgical management of DNM at our department between 2007 and 2011.


RESULTS
We operated on 7 patients (1 female, 6 males) with the mean age of 56.3 years. In 3 cases the infection was of odontogenic origin and in 4 cases of tonsillar origin. Except for one patient with permanent immunosuppression, after kidney transplantation, swab culture showed the original, inciting pathogen to be Streptococcus in all cases; as for anaerobic organisms it was mostly Fusobacterium. In all cases we performed external cervical drainage and mediastinal drainage through a cervical approach. In 3 cases it was necessary to perform mediastinal drainage through thoracotomy. Mean hospital stay was 45.7 days, 30-day mortality was zero.


CONCLUSIONS
The results confirm a better prognosis of DNM compared to mediastinitis caused by oesophageal perforation or oesophageal surgery complication.
I.chirurgicka klinika LF UP a FN Plzen, prednosta. safranek@fnplzen.cz
J
J
Safránek
V
V
Spidlen
T
T
Skalický
J
J
Vodička
J
J
Martínek
P
P
Andrle
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009336:Necrosis