Article Abstract

Clinical characteristic and management of descending necrotizing mediastinitis: a retrospective study, Dr. Soetomo Hospital, Surabaya

Authors: Dhihintia Jiwangga

Abstract

Background: Descending necrotizingmediastinitis (DNM) is a mediastinal infection that is usually an extensionor process of spreading an infection originating from the neck. The spread ofinfection occurs due to the influence of gravity and negative intrathoracicpressure.
Methods: We collect data from medical record patients whopresented with DNM at Dr. Soetomo General Hospital, Surabaya, Indonesia,from January 2013 to December 2017. We collect characteristic data of eachpatient, diagnostic, operative management and outcome.
Results: We have 56 patients met inclusion criteria, Therewere 50 patients came to our hospital with preoperative septicemia. The sourceof infection that we found, odontogenic 30 cases (53.57%), we did cervicotomysubsternal drainage for 54 cases (96.43%), sternotomy 1 (1.79%) and rightthoracotomy 1 (1.79%). Our mortality is 14.29%/5 years.
Conclusions: Transcervical mediastinal drainageand adequate debridement is effective. Transthoracic mediastinal drainage wasdepended on each case. Thoracotomy if locus infection or pus accumulation onpleura. Sternotomy approach if locus infection is wide spreading tomediastinum, right or left pleura.