MEDIASTINITIS - serous or purulent inflammation of the mediastinal tissue. It arises as a complication of purulent diseases of the pleura, lungs, phlegmon of the face and neck, as a result of trauma to the mediastinal organs (for example, perforation of the esophagus by 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 focus of inflammation. This is facilitated by a good blood supply to the mediastinal fiber and the absence of fascial barriers in it. The initial manifestations of the disease are pain behind the sternum (aggravated by striking it) and in the back, chills, fever up to 39–40 ° C, tachycardia , then shortness of breath , hoarseness, and sometimes stupefaction join. The most serious complications: compression or perforation of the mediastinum (trachea, esophagus, large vessels) and sepsis . In diagnostics, an important role belongs to the results of an X-ray examination, in which the expansion and fuzziness of the contours of the shadow of the mediastinum are determined.
If mediastinitis is suspected, the patient should be hospitalized immediately. The treatment is carried out with broad-spectrum antibiotics against the background of massive detoxification therapy with the introduction of solutions of electrolytes, vitamins, protein blood substitutes. Cardiovascular agents are used. When mediastinal abscesses occur and a putrefactive infection is suspected, a mediastinotomy is performed, which allows for active outflow of pus from the lesion. The prognosis for mediastinitis is always serious.