[A successful surgical case of descending necrotizing mediastinitis with fistula formation to the right main bronchus].

Descending necrotizing mediastinitis (DNM) is extremely rare and one of the most lethal forms of mediastinitis, even in the era of antibiotics. We have recently treated a 65-year-old man who was diagnosed as having a fistula to the right main bronchus caused by DNM secondary to a peritonsillar abscess. Surgical treatment consisted in closing the right bronchial fistula and covering it with the latissimus dorsi muscle flap and mediastinal drainage through thoracotomy. Postoperative course was uneventful. This is the second known reported case of a successful operation for DNM with bronchial fistula.