South Clin Ist Euras. 2012; 23(1): 45-48 | DOI: 10.5505/jkartaltr.2012.30932

Desendan nekrotizan mediastinit: Nadir bir olgu

Tülin Durgun Yetim¹, Þemsettin Okuyucu², Sabahat Genç Akoðlu³, Ali Balcý⁴, Güldem Ekþi^2
1Mustafa Kemal Üniversitesi Týp Fakültesi, Göðüs Cerrahisi Anabilim Dalý, Hatay
²Mustafa Kemal Üniversitesi Týp Fakültesi, KBB Hastalýklarý Anabilim Dalý, Hatay
³Mustafa Kemal Üniversitesi Týp Fakültesi, Göðüs Hastalýklarý Anabilim Dalý, Hatay
⁴Mustafa Kemal Üniversitesi Týp Fakültesi, Radyoloji Anabilim Dalý, Hatay

Desendan nekrotizan mediastinit (DNM) nadir, fakat yüksek oranda ölümcül seyreden bir durumdur. Sýklýkla orofarenjeal veya odontojenik þiddetli enfeksiyonlara baðlý geliþen bir
komplikasyondur. Kliniðe, DNM tablosu ile baþvuran 50 yaþýnda kadýn hastada trakeaotomi açýlarak, transservikal giriþimle boyundaki apse drene edildi. Apse lojundaki nekrotik dokulara debridman uygulandý. Çekilen toraks bilgisayarlý tomografisinde ampiyem poþlarý oluþmasý ve retrofarinjeal bölgeden cerahat içeriðinin mediastene yayýlýmý olmasý üzerine dekortikasyon ve ampiyemektomi yapýldý. Mediastinal plevra açýlarak mediasten temizlendi. Hasta sorunsuz olarak taburcu edildi. Derin boyun enfeksiyonuna ikincil geliþen DNM’li olgu nadir görülmesi ve baþarýlý tedavisi nedeniyle
literatür eþiðinde sunuldu.

Anahtar Kelimeler: Desendan nekrotizan mediastinit, derin boyun enfeksiyonu, sekonder

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Descending necrotizing mediastinitis: A rare case

Tülin Durgun Yetim¹, Þemsettin Okuyucu², Sabahat Genç Akoðlu³, Ali Balcý⁴, Güldem Ekþi^2
1Mustafa Kemal University Faculty of Medicine, Department of Thoracic Surgery, Hatay, Turkey
²Mustafa Kemal University Faculty of Medicine, Department of Otorhinolaringology, Hatay, Turkey
³Mustafa Kemal University Faculty of Medicine, Department of Chest Diseases, Hatay, Turkey
⁴Mustafa Kemal University Faculty of Medicine, Department of Radiology, Hatay, Turkey

Descending necrotizing mediastinitis (DNM) is a rare fatal complication. It mostly develops due to severe oropharyngeal or odontogenic infections. A 50-year-old female patient who admitted to our department with the diagnosis of DNM underwent tracheotomy, and the abscess in her neck was drained with transcervical resection. Necrotic tissue in the area was debrided. Since thorax computerized tomography revealed formation of empyema pouches and emission of pus content from the retropharyngeal area into the mediastinum, decortication and empyemectomy were performed. The mediastinal pleura was resected and the mediastinum was cleaned. The patient was discharged with full recovery. Descending mediastinitis secondary to a deep neck infection is a rare occurrence. This study aims to share this successfully treated case in the light of the literature.

Keywords: Descending necrotizing mediastinitis, deep neck infection, secondary

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