Abstract
A 21-year-old man with an oropharyngeal abscess admitted to our institution was initially treated with systemic antibiotics but was referred to our department when his condition rapidly deteriorated. His respiratory insufficiency required circulatory support A computed tomographic scan showed a parapharyngeal abscess descending into the mediastinum with multiple right-side capsulized empyema and pericardial effusion. We conducted emergency surgery through a mediansternotomy using a pedicled omental flap. Postoperative clinical and radiologic assessment showed a normal chest X-ray and primary wound healing without sternal dehiscence. Mediansternotomy using a pedicled omental flap offers excellent exposure for a complete one-stage operation with debridement of all affected tissues of the subauricular region, the mediastinum, and both pleural cavities. We conclude that this method yields good results for patients with acute widespread descending necrotizing mediastinitis.
Similar content being viewed by others
References
Mikami K, Izumi H, Masuda S. Descending necrotizing mediastinitis secondary to retropharyngeal abscessa case report (Eng abstr). J Jpn Assn Thorac Surg 1997; 45: 1096–101.
Wheatley MJ, Stirling MC, Kirsh MM. Descending necrotizing mediastinitis: trascervical drainage is not enough. Ann Thorac Surg 1990; 49: 780–4.
Ris HB, Banic A, Furrer M. Descending necrotizing mediastinitis: surgical treatment via clamshell approach. Ann Thorac Surg 1996; 62: 1650–4.
Roberts JR, Simythe R, Weber RW. Thoracoscopic management of descending necrotizing mediastinitis. Chest 1997; 112: 850–4.
Kiernan PD, Hernandez A, Byrne WD. Descending cervical mediastinitis. Ann Thorac Surg 1998; 65: 1483–7.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Narimatsu, M., Baba, H., Hazama, S. et al. Successfully treated descending necrotizing mediastinitis through mediansternotomy using a pedicled omental flap. Jpn J Thorac Caridovasc Surg 48, 447–450 (2000). https://doi.org/10.1007/BF03218173
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03218173