What kind of disease is mediastinitis?

summary

What kind of disease is mediastinitis? Mediastinitis refers to bacterial infection in the mediastinum, which is divided into acute and chronic. Acute mediastinitis often forms abscess, and the condition is serious. Chronic mediastinitis is mostly granulomatous, which is often caused by primary pulmonary tuberculosis or histoplasmosis infection. The onset is slow and often asymptomatic. In X-ray examination, it is found that a small number of patients can also have corresponding symptoms and signs due to obstruction or compression caused by lesions.

What kind of disease is mediastinitis?

The etiology of acute mediastinitis is secondary. The common causes include penetrating chest trauma, rupture of esophagus or trachea, perforation of esophagus caused by foreign body in pharynx, anastomotic leakage after esophageal surgery, perforation of esophagus by esophagoscopy and perforation of esophageal cancer ulcer. It often occurs during vomiting, and occasionally is caused by the direct spread of infection foci in adjacent tissues such as the posterior cavity of esophagus, lung, pleural lymph nodes, pericardium, etc.

Mediastinitis is often caused by tuberculosis, histoplasmosis, actinomycetes, sarcoidosis, syphilis, posttraumatic mediastinal hemorrhage and drug poisoning, which can cause mediastinal fibrosis. It may also be related to autoimmunity. The etiology of some patients is unknown.

Acute mediastinitis may have a related history. The typical manifestations are acute onset, chills, high fever, severe pain behind the sternum, and radiation to the neck, behind the ear, or between the whole chest and both sides of the scapula. Physical examination showed shortness of breath, rapid heartbeat, obvious systemic poisoning symptoms, tenderness of sternum, enlarged boundary of mediastinal voiced sound, mediastinal friction sound and fragmented sound synchronized with heart sound; The symptoms of trachea displacement and jugular vein distention may also occur due to the compression of mediastinum.

matters needing attention

Treatment principle: clear the cause, drainage as soon as possible, control infection, nutritional support. Mainly for the primary disease and etiology of treatment. Tracheoplasty is feasible for the patients with mediastinal trauma and tracheal rupture. For patients with esophageal rupture or anastomotic leakage, esophageal repair, fasting and rehydration, and gastrointestinal decompression are feasible. Mediastinal drainage is necessary. Culture of pus and selection of sensitive antibiotics are beneficial to treatment.