Habib Khan1, Sanjay Asopa1, Salil Nair2, Eunan Tiernan3 and Khalid A Amer1*
1The Cardiovascular & Thoracic Centre, University Hospital Southampton, UK
2Department of Otolaryngology, University Hospital Southampton, UK
3Department of Plastic Surgery, Salisbury District Hospital, UK
A thoracic surgeon in the UK is likely to come across Descending Necrotizing Mediastinitis once a year in a busy tertiary referral hospital. This is a rare but life-threatening complication of oropharyngeal sepsis. It carries a poor prognosis if recognised late. In this report we selectively describe five cases treated differently, with emphasis on Computed Tomography guidance to bespoke surgical drainage of pus. We specifically discuss two aspects of our experience with these patients. Firstly the spectrum of surgical management and role of Video Assisted Thoracoscopic Surgery (VATS). Secondly we discuss “dysphagia”, which is invariably a presenting symptom/ complication, its progression, and natural course. We also emphasise the important role of different teams on the Intensive Therapy Unit as a major cause of these patients surviving the gruesome infection.
Video assisted thoracoscopic surgery; Necrotizing Mediastinitis; Spectrum
Khan H, Asopa S, Nair S, Tiernan E, Amer KA. Acute Descending Necrotizing Mediastinitis: Spectrum of Management and Role of Video Assisted Thoracoscopic Surgery. Clin Surg. 2017; 2: 1482.