Korean J Thorac Cardiovasc Surg.  2002 Feb;35(2):161-165.

Management of Descending Necrotizing Mediastinitis with Thoracoscopy

• Lee SH
• Sun K
• Kim KT

Abstract

Descending necrotizing mediastinitis is a life-threatening infection originating in the head or the neck and descends into the mediastinum. Even in the era of antibiotics, mortality rate has been reported to be 25~40%. Prompt diagnosis and treatment is mandatory for delayed diagnosis and inappropriate drainage of the mediastinum are the main causes of high mortality. Surgical management ranges from cervical drainage to routine thoracotomy: however, the optimal management still needs to be defined particularly in respect to effective mediastinal drainage. Although posterolateral thoracotomy incision has been considered as a standard approach, potential disadvantages including postoperative pain, risk of wound complication and delayed recovery remain to be concerned. Thoracoscopic approach is an attractive treatment modality as it can provide an excellent exposure with minimal incision and can complete drainage from the mediastinum and the neck in one-staged manner. We describe here two cases of descending necrotizing mediastinitis successfully managed by thoracoscopic drainage.

Keyword

Thoracoscopy; Descending necrotizing mediastinitis

MeSH Terms

Anti-Bacterial Agents
Delayed Diagnosis
Diagnosis
Drainage
Head
Mediastinitis*
Mediastinum
Mortality
Neck
Pain, Postoperative
Thoracoscopy*
Thoracotomy
Wounds and Injuries
Anti-Bacterial Agents