Descending necrotizing mediastinitis

Background: 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 re...

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Main Authors: Cvijanović Vlado, Stanić Vojkan, Ristanović Aleksandar, Gulić Bojan, Durković Savo, Stamenović Davor, Marić Nebojša
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2006-01-01
Series:Vojnosanitetski Pregled
Subjects:
Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2006/0042-84500607677C.pdf
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author Cvijanović Vlado
Stanić Vojkan
Ristanović Aleksandar
Gulić Bojan
Durković Savo
Stamenović Davor
Marić Nebojša
author_facet Cvijanović Vlado
Stanić Vojkan
Ristanović Aleksandar
Gulić Bojan
Durković Savo
Stamenović Davor
Marić Nebojša
author_sort Cvijanović Vlado
collection DOAJ
description Background: 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 controversial. The reason for publishing this report is both the fact that DNM is very rare and our experience preferring thoracotomy as an optimal approach to treating the disease. Case report. 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 because of massive bleeding caused by septic erosion. There were no more reoperations. Conclusion. Aggressive surgical treatment, regardless the localization and the extent of changes is the key to success in the treatment of patients with necrotizing mediastinitis.
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series Vojnosanitetski Pregled
spelling doaj-art-375b7403fd0247d2ba9982b3d93474ca2025-08-20T02:07:46ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502006-01-0163767768010.2298/VSP0607677CDescending necrotizing mediastinitisCvijanović VladoStanić VojkanRistanović AleksandarGulić BojanDurković SavoStamenović DavorMarić NebojšaBackground: 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 controversial. The reason for publishing this report is both the fact that DNM is very rare and our experience preferring thoracotomy as an optimal approach to treating the disease. Case report. 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 because of massive bleeding caused by septic erosion. There were no more reoperations. Conclusion. Aggressive surgical treatment, regardless the localization and the extent of changes is the key to success in the treatment of patients with necrotizing mediastinitis.http://www.doiserbia.nb.rs/img/doi/0042-8450/2006/0042-84500607677C.pdfmediastinitisnecrosispleuradrainagethoracotomy
spellingShingle Cvijanović Vlado
Stanić Vojkan
Ristanović Aleksandar
Gulić Bojan
Durković Savo
Stamenović Davor
Marić Nebojša
Descending necrotizing mediastinitis
Vojnosanitetski Pregled
mediastinitis
necrosis
pleura
drainage
thoracotomy
title Descending necrotizing mediastinitis
title_full Descending necrotizing mediastinitis
title_fullStr Descending necrotizing mediastinitis
title_full_unstemmed Descending necrotizing mediastinitis
title_short Descending necrotizing mediastinitis
title_sort descending necrotizing mediastinitis
topic mediastinitis
necrosis
pleura
drainage
thoracotomy
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2006/0042-84500607677C.pdf
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AT gulicbojan descendingnecrotizingmediastinitis
AT durkovicsavo descendingnecrotizingmediastinitis
AT stamenovicdavor descendingnecrotizingmediastinitis
AT maricnebojsa descendingnecrotizingmediastinitis