MEDIASTINITIS - serous or purulent inflammation of the cellulose mediastinum. Occurs as a complication of purulent diseases of the pleura, lungs, face and neck phlegmon, as a result of injury of the mediastinal organs (for example, esophageal perforation with a foreign body), during endoscopic examination or after surgery.
The clinical picture is determined by severe purulent intoxication as a result of the rapid absorption of toxic products from the source of inflammation. This is facilitated by a good blood supply to the fiber of the mediastinum and the absence of fascial barriers in it. The initial manifestations of the disease are pain behind the sternum (aggravated by tapping on it) and in the back, chills, an increase in body temperature to 39–40 ° C, tachycardia , then shortness of breath , hoarseness, sometimes confusion. The most severe complications: compression or perforation of the mediastinal organs (trachea, esophagus, large vessels) and sepsis . In the diagnosis of an important role belongs to the results of x-ray examination, which determines the expansion and fuzziness of the contours of the shadow of the mediastinum.
If you suspect a mediastinitis patient should be hospitalized immediately. The treatment is carried out with broad-spectrum antibiotics on the background of massive detoxification therapy with the introduction of electrolyte solutions, vitamins, protein blood substitutes. Apply cardiovascular agents. At occurrence of mediastinal abscesses and suspicion of putrefactive infection, mediastinotomy is produced, which allows for the active outflow of pus from the lesion. The prognosis for mediastinitis is always serious.