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Mediastinoscopic drainage for descending necrotizing mediastinitis


A case of descending necrotizing mediastinitis that was treated by mediastinoscopic drain- age is reported. The patient was a 56-year-old diabetic woman. A hypopharyngeal abscess extended to the mediastinum through the neck. No septic condition was noted. Chest CT showed that the abscess reached 4 cm below the tracheal bifurcation. Pus was drained under direct observation by mediastinoscopy, and a drain was placed in an appropriate position. After operation, lavage was performed through the drain, and cure was achieved on the 42nd postoper- ative day. This technique should be considered as surgical treatment for descending necrotizing mediastinitis in the absence of serious complication such as sepsis, because it has a more reliable drainage effect than the conventional transcervical method, and because it is less invasive than thoracotomy.

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Correspondence to Kiyoshi Ohno M.D..

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Ohno, K., Yamasaki, Y., Hatanaka, N. et al. Mediastinoscopic drainage for descending necrotizing mediastinitis. Jpn J Thorac Caridovasc Surg 46, 175–178 (1998).

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  • Diabetic Woman
  • Septic Condition
  • Pleural Drainage
  • Tracheal Bifurcation