Descending Necrotising Mediastinitis: A Case Report Illustrating a Trend in Conservative Management
The mortality rate from descending necrotising mediastinitis (DNM) has declined since its first description in 1938. The decline in mortality has been attributed to earlier diagnosis by way of contrast-enhanced computed tomographic (CT) scanning and aggressive surgical intervention in the form of tr...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Case Reports in Otolaryngology |
| Online Access: | http://dx.doi.org/10.1155/2012/504219 |
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| _version_ | 1832559058425479168 |
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| author | B. A. P. Jayasekera O. T. Dale R. C. Corbridge |
| author_facet | B. A. P. Jayasekera O. T. Dale R. C. Corbridge |
| author_sort | B. A. P. Jayasekera |
| collection | DOAJ |
| description | The mortality rate from descending necrotising mediastinitis (DNM) has declined since its first description in 1938. The decline in mortality has been attributed to earlier diagnosis by way of contrast-enhanced computed tomographic (CT) scanning and aggressive surgical intervention in the form of transthoracic drainage. We describe a case of DNM with involvement of anterior and posterior mediastinum down to the diaphragm, managed by cervicotomy and transverse cervical drainage with placement of corrugated drains and a pleural chest drain, with a delayed mediastinoscopy and mediastinal drain placement. We advocate a conservative approach with limited debridement and emphasis on drainage of infection in line with published case series. |
| format | Article |
| id | doaj-art-2007e8b9419b4af8a4e3eb1b3c31c03f |
| institution | Kabale University |
| issn | 2090-6765 2090-6773 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Otolaryngology |
| spelling | doaj-art-2007e8b9419b4af8a4e3eb1b3c31c03f2025-02-03T01:30:52ZengWileyCase Reports in Otolaryngology2090-67652090-67732012-01-01201210.1155/2012/504219504219Descending Necrotising Mediastinitis: A Case Report Illustrating a Trend in Conservative ManagementB. A. P. Jayasekera0O. T. Dale1R. C. Corbridge2Department of General Surgery, Royal Berkshire Hospital, Reading RG1 5AN, UKDepartment of ENT, Royal Berkshire Hospital, Reading RG1 5AN, UKDepartment of ENT, Royal Berkshire Hospital, Reading RG1 5AN, UKThe mortality rate from descending necrotising mediastinitis (DNM) has declined since its first description in 1938. The decline in mortality has been attributed to earlier diagnosis by way of contrast-enhanced computed tomographic (CT) scanning and aggressive surgical intervention in the form of transthoracic drainage. We describe a case of DNM with involvement of anterior and posterior mediastinum down to the diaphragm, managed by cervicotomy and transverse cervical drainage with placement of corrugated drains and a pleural chest drain, with a delayed mediastinoscopy and mediastinal drain placement. We advocate a conservative approach with limited debridement and emphasis on drainage of infection in line with published case series.http://dx.doi.org/10.1155/2012/504219 |
| spellingShingle | B. A. P. Jayasekera O. T. Dale R. C. Corbridge Descending Necrotising Mediastinitis: A Case Report Illustrating a Trend in Conservative Management Case Reports in Otolaryngology |
| title | Descending Necrotising Mediastinitis: A Case Report Illustrating a Trend in Conservative Management |
| title_full | Descending Necrotising Mediastinitis: A Case Report Illustrating a Trend in Conservative Management |
| title_fullStr | Descending Necrotising Mediastinitis: A Case Report Illustrating a Trend in Conservative Management |
| title_full_unstemmed | Descending Necrotising Mediastinitis: A Case Report Illustrating a Trend in Conservative Management |
| title_short | Descending Necrotising Mediastinitis: A Case Report Illustrating a Trend in Conservative Management |
| title_sort | descending necrotising mediastinitis a case report illustrating a trend in conservative management |
| url | http://dx.doi.org/10.1155/2012/504219 |
| work_keys_str_mv | AT bapjayasekera descendingnecrotisingmediastinitisacasereportillustratingatrendinconservativemanagement AT otdale descendingnecrotisingmediastinitisacasereportillustratingatrendinconservativemanagement AT rccorbridge descendingnecrotisingmediastinitisacasereportillustratingatrendinconservativemanagement |