Mediastinitis
From WikiLectures
Acute mediastinitis
Acute mediastinitis is a serious disease with a high lethality (approximately 50%).
- Usually a consequence of perforation of the oesophagus (endoscopic procedures, tumours), rarely a complication of pneumonia/mediastinitis (possibly lung abscess, empyema) or even as a complication of coemphysitis.
Clinical picture
- Fever with retrosternal pain,
- with esophageal perforation dysphagia + subcutaneous emphysema,
- X-ray: enlargement of the mediastinum, ev. with pleural effusion + mediastinal emphysema.
Therapy
- ATB i.v., mediastinal drainage.}
Chronic mediastinitis
Chronic mediastinal inflammation is a granulomatous, fibrous process of mostly unclear etiology. The occurrence of this disease is rare.
- Ormond's disease = idiopathic mediastinal fibrosis + retroperitoneal fibrosis.
Clinical picture
- At the beginning without difficulty,
- later upper vena cava syndrome, esophageal stenosis + tracheobronchial tree stenosis,
- X-ray: enlargement of the upper mediastinum, rarely calcification.
Therapy
- Surgical removal of mechanical compression, glucocorticoids.
Links
Related Articles
Bibliography
- DÍTĚ, Petr. Vnitřní lékařství. 2. edition. 2007. ISBN 978-80-7262-496-6.
