[Computed tomography in acute mediastinitis].

Acute mediastinitis (AM) has become a rare disease since the introduction of antibiotics but still has an unchanged high mortality-rate if the diagnosis is not readily established, and adequate therapy is performed. Clinical signs of AM are often uncharacteristic, plain chest films do not allow a reliable diagnosis because of lack of sensitivity as well as specificity. In a retrospective study the CT-results of 23 patients clinically suspect for AM were evaluated in order to determine the diagnostic value of CT-findings were compared to operation, percutaneous drainage procedures and clinical course. In 15 patients the diagnosis of AM was established correctly by CT, 8 patients were reported normal. Diffuse infiltration of mediastinal fatty tissue was found in 3 patients, mediastinal fluid collections were demonstrated in 12 (infected hematomas = 4, abscess formation = 8). The extension of inflammatory changes could be exactly assessed by CT in all patients.