Rozhledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti · 2024
Descending necrotizing mediastinitis - a surgical view.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Šafránek J
Аннотация
INTRODUCTION: Descending necrotizing mediastinitis (DNM) is a relatively uncommon but serious type of inflammation. Even today, the mortality is around 20%. An overview of DNM issues, recent literature and clinical practice of our department is presented. Anatomy and etiology: The cause is the descent of an originally oropharyngeal infection from the deep neck space into the mediastinum.
THERAPY: Treatment takes place in an intensive care department, with a combination of antibiotics. Elimination of the neck source of inflammation is a prerequisite. The type of surgical drainage depends on the stage and extent of mediastinal involvement. Cervicomediastinal, mediastinothoracic, or cervicomediastinothoracic "Rendezvous" drainage are options.
CONCLUSION: The basis of DNM treatment is adequate surgical drainage, but interdisciplinary care (surgeon, anesthesiologist, ENT and dental surgeon) is a necessary condition.
THERAPY: Treatment takes place in an intensive care department, with a combination of antibiotics. Elimination of the neck source of inflammation is a prerequisite. The type of surgical drainage depends on the stage and extent of mediastinal involvement. Cervicomediastinal, mediastinothoracic, or cervicomediastinothoracic "Rendezvous" drainage are options.
CONCLUSION: The basis of DNM treatment is adequate surgical drainage, but interdisciplinary care (surgeon, anesthesiologist, ENT and dental surgeon) is a necessary condition.