Clinical Diagnostics of Patients with Acute Purulent Mediastinitis
Abstract
The objective of the study. To conduct an analysis of clinical diagnosis, symptoms and purulent mediastinal syndromes in patients with acute purulent mediastinitis (APM).
Materials and methods of research. During 2000-2018 there were 65 patients with APM in the thoracic department of the Ivano-Frankivsk Regional Clinical Hospital.
Research results. Clinical picture of APM consists of symptoms of the main disease and local manifestations of purulent process in the mediastinum: chest pain - in 62 (95.4%) patients, iPNiltrative changes and hyperemia of the thoracic wall were observed in 13 (20%), mediastinal emphysema at 29 ( 44.6%); general symptoms of endogenous intoxication: increased body temperature in 100% of patients, pallor of the skin in 34 (52.3%), cyanotic changes - in 24 (36.9%), shortness of breath - 37 (56.9%), tachycardia in 100% patients; clinical symptoms of damage to other organs of the mediastinum and chest: upper respiratory tract syndrome in 11 (16.9%), dysphagia in 9 (13.8%), hiccup in 2 (3.1%), hoarseness of voice in 6 (9.2%), cough - 23% (35.4%), exudative pleurisies - 6% (78.4%) and purulent pericarditis - in 18 (27.6%) patients.
Conclusions.
- Knowledge of the symptoms and syndromes of acute purulent mediastinitis is the basis for timely diagnosis of this disease.
- A clear clinical interpretation of the symptoms of acute purulent mediastinitis allows suspect this disease already at the initial stages of providing medical care.
- Early diagnosis of acute purulent mediastinitis is one of the decisive factors in the successful treatment of patients.
References
Abakumov MM, Pogodina AN, Barmina TG, Snigirev MV. Twenty years of experience in diagnostics and treatment various forms of purulent mediastinitis. Vestn khir, 2001; 1: 80-85.
Slesarenko SS, Agapov VV, Prelatov VA. Mediastinitis. M: Medpraktika; 2005. 200.
Shevchuk IM, Snizhko SS. Surgical treatment of purulent descending mediastinitis complicated by sepsis. Shpital. khirurgiya, 2013; 4 (64): 105-107.
Shevchuk IM, Snizhko SS. Causes and ways of the spread of the neck phlegmon complicated by descending purulent mediastinitis. Khirurgiya. Vostochnaya Evropa, 2014; 4 (12); 9-15.
Akallal. N. Descending necrotizing mediastinitis: a diagnosis not to miss. Rev Pneumol Clin, 2002; 58: 355-358. [PMid:12545135]
Cariati P, Monsalve-Iglesias F, Cabello-Serrano F, Valencia-Laseca A, Garcia-Medina B. Cervical necrotizing fasciitis and acute mediastinitis of odontogenic origin: A case series. J Clin Exp Dent. 2017; 9(1): 150-152.
Gregor J. Kocher, Beatrix Hoksch, Marco Caversaccio, Jan Wiegand, Ralph A. Schmid. European Journal of Cardio-Thoracic Surgery, 2012; 42(4): 66-72. DOI: https://doi.org/10.1093/ejcts/ezs385 [PMid:22761501]
Copyright (c) 2018 Sergiy Snizhko
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