Zusammenfassung
Die Mediastinitis ist mit einer Letalität von bis zu 70 % eine der lebensbedrohlichsten akuten Erkrankungen des Thorax. Aufgrund der raschen Ausbreitung der Entzündung im lockeren Bindegewebe mit Übergreifen auf den Hals und das Retroperitoneum entwickelt sich in kürzester Zeit ein schweres septisches Krankheitsbild. Häufigste Ursachen der Mediastinitis sind neben Verletzungen der Trachea oder des Ösophagus postoperative Entzündungen bzw. Sekundärheilungen nach kardio- bzw. thoraxchirurgischen Eingriffen sowie deszendierende Infektionen durch Übergreifen von odontogenen oder zervikalen Entzündungen auf den Mittelfellraum. Dieses Kapitel gibt eine Übersicht über die Therapie der deszendierenden Mediastinitis und der postoperativen Infektion nach Sternotomie. Die Behandlung dieser Krankheitsbilder sollte aufgrund der Komplexität dem Kardio- bzw. Thoraxchirurgen anvertraut werden. Darüber hinaus werden die Ingestion von Fremdkörpern und Ösophagusperforationen (u. a. Boerhaave-Syndrom) abgehandelt.
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Utzig, M., Sikora, A. (2018). Differenzialdiagnostik und Therapie der Mediastinitis. In: Schneider, P., Kruschewski, M., Buhr, H. (eds) Thoraxchirurgie für den Allgemein- und Viszeralchirurgen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48710-5_26
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