気管縦隔瘻をきたした降下性壊死性縦隔炎例

DOI Web Site Web Site 参考文献2件

書誌事項

タイトル別名
  • A Case of Descending Necrotizing Mediastinitis Causing a Tracheomediastinal Fistula
  • キカン ジュウカクロウ オ キタシタ コウカセイ エシセイ ジュウカクエンレイ

この論文をさがす

抄録

<p>Descending necrotizing mediastinitis (DNM) can occasionally complicate a deep neck infection, and has a high mortality rate. Thus, rapid diagnosis and prompt surgical intervention are essential. We encountered a rare case of DNM with the formation of a tracheomediastinal fistula. Tracheomediastinal fistula is a potentially life-threatening complication. To the best of our knowledge, only four reported cases have been successfully saved. Our patient was a 79-year-old male patient who presented with the chief complaint of dyspnea. CT imaging showed a retropharyngeal abscess with gas extending widely over the mediastinum. We performed transcervical and transthoracic drainage, combined with antimicrobial therapy. After the drainage operation, bronchoscopy revealed a tracheomediastinal fistula. Due to the relatively good respiratory condition, we selected conservative treatments, such as fibrin glue sealing and saline irrigation via a drain. As the patient developed the complication of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and pyogenic discitis between the fourth and fifth thoracic vertebrae during the course of treatment, we administered anti-MRSA antibiotics and performed another drainage surgery. The patient responded to these treatments, with eventual cure and closure of the tracheomediastinal fistula.</p>

収録刊行物

参考文献 (2)*注記

もっと見る

キーワード

詳細情報 詳細情報について

問題の指摘

ページトップへ