Acute Descending Necrotizing Mediastinitis: Spectrum of Management and Role of Video Assisted Thoracoscopic Surgery

Habib Khan, Sanjay Asopa, Salil Nair, Eunan Tiernan and Khalid A Amer

The Cardiovascular & Thoracic Centre, University Hospital Southampton, UK
Department of Otolaryngology, University Hospital Southampton, UK
Department of Plastic Surgery, Salisbury District Hospital, UK

^*Correspondance to: Khalid A Amer 

 PDF  Full Text DOI: 10.25107/2474-1647.1482

Abstract

A thoracic surgeon in the UK is likely to come across Descending Necrotizing Mediastinitis once a year in a busy tertiary referral hospital. This is a rare but life-threatening complication of oropharyngeal sepsis. It carries a poor prognosis if recognised late. In this report we selectively describe five cases treated differently, with emphasis on Computed Tomography guidance to bespoke surgical drainage of pus. We specifically discuss two aspects of our experience with these patients. Firstly the spectrum of surgical management and role of Video Assisted Thoracoscopic Surgery (VATS). Secondly we discuss “dysphagia”, which is invariably a presenting symptom/ complication, its progression, and natural course. We also emphasise the important role of different teams on the Intensive Therapy Unit as a major cause of these patients surviving the gruesome infection.

Keywords

Video assisted thoracoscopic surgery; Necrotizing Mediastinitis; Spectrum

Cite the article

Khan H, Asopa S, Nair S, Tiernan E, Amer KA. Acute Descending Necrotizing Mediastinitis: Spectrum of Management and Role of Video Assisted Thoracoscopic Surgery. Clin Surg. 2017; 2: 1482.