Desendan nekrotizan mediastinit : Nadir bir olgu
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Tarih
2012
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info:eu-repo/semantics/openAccess
Özet
Desendan nekrotizan mediastinit (DNM) nadir, fakat yüksek oranda ölümcül seyreden bir durumdur. Sıklıkla orofarenjeal veya odontojenik şiddetli enfeksiyonlara bağlı gelişen bir komplikasyondur. Kliniğe, DNM tablosu ile başvuran 50 yaşında kadın hastada trakeaotomi açılarak, transservikal girişimle boyundaki apse drene edildi. Apse lojundaki nekrotik dokulara debridman uygulandı. Çekilen toraks bilgisayarlı tomografisinde ampiyem poşları oluşması ve retrofarinjeal bölgeden cerahat içeriğinin mediastene yayılımı olması üzerine dekortikasyon ve ampiyemektomi yapıldı. Mediastinal plevra açılarak mediasten temizlendi. Hasta sorunsuz olarak taburcu edildi. Derin boyun enfeksiyonuna ikincil gelişen DNM’li olgu nadir görülmesi ve başarılı tedavisi nedeniyle literatür eşiğinde sunuldu.
Descending necrotizing mediastinitis (DNM) is a rare fatal complication. It mostly develops due to severe oropharyngeal or odontogenic infections. A 50-year-old female patient who admitted to our department with the diagnosis of DNM underwent tracheotomy, and the abscess in her neck was drained with transcervical resection. Necrotic tissue in the area was debrided. Since thorax computerized tomography revealed formation of empyema pouches and emission of pus content from the retropharyngeal area into the mediastinum, decortication and empyemectomy were performed. The mediastinal pleura was resected and the mediastinum was cleaned. The patient was discharged with full recovery. Descending mediastinitis secondary to a deep neck infection is a rare occurrence. This study aims to share this successfully treated case in the light of the literature.
Descending necrotizing mediastinitis (DNM) is a rare fatal complication. It mostly develops due to severe oropharyngeal or odontogenic infections. A 50-year-old female patient who admitted to our department with the diagnosis of DNM underwent tracheotomy, and the abscess in her neck was drained with transcervical resection. Necrotic tissue in the area was debrided. Since thorax computerized tomography revealed formation of empyema pouches and emission of pus content from the retropharyngeal area into the mediastinum, decortication and empyemectomy were performed. The mediastinal pleura was resected and the mediastinum was cleaned. The patient was discharged with full recovery. Descending mediastinitis secondary to a deep neck infection is a rare occurrence. This study aims to share this successfully treated case in the light of the literature.
Açıklama
Anahtar Kelimeler
Genel ve Dahili Tıp
Kaynak
Kartal Eğitim ve Araştırma Hastanesi Tıp Dergisi
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Cilt
23
Sayı
1