Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Mediastinitis: a case report

종격동염의 증례보고

  • Kim, Jae-Hwan (Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong) ;
  • Ryu, Dong-Mok (Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong) ;
  • Jee, Yu-Jin (Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong) ;
  • Lee, Jung-Woo (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University) ;
  • Lee, Deok-Won (Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong)
  • 김재환 (강동경희대학교 치과대학병원 구강악안면외과) ;
  • 류동목 (강동경희대학교 치과대학병원 구강악안면외과) ;
  • 지유진 (강동경희대학교 치과대학병원 구강악안면외과) ;
  • 이정우 (경희대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 이덕원 (강동경희대학교 치과대학병원 구강악안면외과)
  • Received : 2010.09.26
  • Accepted : 2010.12.21
  • Published : 2010.12.31
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Abstract

Acute mediastinitis is a fatal infection which occurs related to connective tissue of mediastium, in the thoratic organs. Occurrence of mediastinitis due to craniocervical infection is very rare, and is defined as descending necrotizing mediastinitis. November 8th, 2008, man in his early fifties visited ER due to severe swelling on left neck area and dyspnea. Antibiotic were administered immediately, and vast amount of abscess formation on pneumomediastinum and adjacent tissues were observed via chest computed tomography. With cooperation of thoracic and cardiovascular surgery department, emergency incision and drainage with drain insertion was done to remove abscess, and control the infection. After surgery, everyday saline irrigation through drain was done during hospitalization, with continues antibiotic therapy. Descending necrotising mediastinitis is a most rare and dangerous infection which occurs on oropharyngeal area. In case of descending necrotising mediastinitis, accurate diagnosis, airway maintenance, remove of abscess by incision and drainage, aggressive antibiotic therapy and continuous saline irrigation is necessary to increase patient survivability. Also, computed tomography with contrast media is essential to figure out the size and location of the infection and abscess formation.

Keywords

References

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