eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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2/2023
vol. 20
 
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abstract:
Original paper

Descending necrotizing mediastinitis: a challenging infection. Selected results of a Moroccan bicentric study

Massine El Hammoumi
1
,
Saloua Ouraini
2
,
Mohammed Bhairis
1
,
Hamid Kouatli
1
,
Kemini Marius Kamdem
1
,
El Hassane Kabiri
1

  1. Department of Thoracic Surgery, Military Teaching Hospital Mohammed V, Rabat, Morocco
  2. ORL Department, Military teaching Hospital Mohammed V, Rabat, Morocco
Kardiochirurgia i Torakochirurgia Polska 2023; 20 (2): 100-104
DOI: https://doi.org/10.5114/kitp.2023.129541
Online publish date: 2023/07/26
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Introduction:
Mediastinal infection is a persistent and difficult widespread infectious disease caused by secondary complications of adjacent organs. It spreads easily and is often misdiagnosed because of the lack of typical manifestations.

Material and methods:
To highlight the clinical features, medical and surgical strategy of descending necrotizing mediastinitis we performed a retrospective study of 25 documented cases during a 10-year period at our hospital, all treated surgically, 10 from the ORL department and 15 from our thoracic surgery department.

Results:
Patients were aged from 20 to 84 years, with a median age of 41 years, male predominance (19 men and 6 women), sex ratio of 3.6. A cervicotomy (in 40% of cases) was associated or not with videothoracoscopy (one case) or thoracotomy (in 20% of cases) and wide-spectrum antibiotherapy. In the postoperative period, an irrigation-suction system was used on the drains in 15 patients. In 1 case a rethoracotomy was necessary to remove a residual right pyothorax, and one patient required a tracheostomy. Twenty-two (88%) patients recovered from their mediastinitis. Death of 3 patients by sepsis multiorgan failure occurred. Postoperative follow-up during one year was uneventful without recurrence.

Conclusions:
According to our experience, we believe the more aggressive local treatment is, the better are the results.

keywords:

mediastinitis, abscess, necrotizing mediastinal infection
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