Experience on Diagnosis of Descending Necrotizing Mediastinitis at Viet Duc Hospital
Keywords:
Descending necrotizing mediastinitis, esophageal perforation, Ludwig’s anginaAbstract
Background: Descending Necrotizing Mediastinitis (DNMs) are rare and are serious infections with a high mortality rate which complicates from pharyngeal, odontogenic infection or esophageal perforation. Early recognition and treatment are essential in order to minimize morbidity and mortality. Evaluation with imaging diagnosis, especially with computed tomography is necessary to confirm the diagnosis, and facilitate surgical planning. It is an important diagnostic method showing widened mediastinum, air-fluid level in mediastinum and subcutaneous crackling. Estrera’s criterias could be implemented for diagnosis of DNMs. We present one serie of 19 cases diagnosed with DNMs, with characteristic imaging findings. From this study we found that most of DNMs in Vietnam are commonly caused by esophageal perforation and we recommend to perform fibro-gastroendoscopy associated with CT for purposes of diagnosis and intervention. It also helps to locate the esophageal perforation.
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