Successful video-thoracoscopic drainage for descending necrotizing mediastinitis |
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Authors: | Yukio Nakamura Akihide Matsumura Hiroshi Katsura Masahiro Sakaguchi Norimasa Ito Naoto Kitahara Naoko Ose |
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Institution: | (1) Department of Surgery, National Hospital Organization Kinki-chuo Chest Medical Center, 1180 Nagasone-cho, Sakai, Osaka 591-8555, Japan |
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Abstract: | Descending necrotizing mediastinitis (DNM) is a rare but severe disease with a high mortality rate. We report a case of a
77-year-old woman with DNM who was treated using video-thoracoscopic drainage and a Blake drain. She was admitted to our hospital
with a 3-day history of a sore throat. Computed tomography (CT) revealed a peritonsillar abscess descending into the anterior
and posterior mediastinum below the carina. She was diagnosed with DNM, and emergency surgery was performed. The mediastinal
abscess was drained via video-thoracoscopy, and a 24F Blake drain was inserted into the mediastinum. Following mediastinal
drainage, cervical drainage was performed for treatment of the retropharyngeal abscess. The outcome of videothoracoscopic
mediastinal drainage was satisfactory, and no further invasive treatment was required. We believe that video-thoracoscopic
mediastinal drainage is an effective, minimally invasive treatment for DNM with subcarinal spread. Blake drains are useful
for mediastinal drainage. |
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Keywords: | Blake drain Video-thoracoscopic drainage Descending necrotizing mediastinitis |
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