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Infections of the mediastinum

Kalliopi A Athanassiadi1

  • 1Department of Thoracic Surgery, General Hospital of Piraeus, Athens-Greece, 34A Konstantinoupoleosstr., Holargos, 15562 Athens, Greece. kallatha@otenet.gr

Thoracic Surgery Clinics
|March 18, 2009
PubMed

Insights

Mediastinitis, serious infections of the mediastinum, can arise from various causes including surgery. Treatment for acute mediastinitis targets the primary cause, while chronic forms have limited surgical options.

Area of Science:

  • Infectious Diseases
  • Thoracic Surgery
  • Anatomy

Background:

  • Mediastinitis, infections of the mediastinum, present significant morbidity and mortality.
  • Causes include direct extension, hematogenous spread, or direct introduction into the mediastinal space.
  • Common causes are esophageal perforation, penetrating trauma, and post-surgical infections, with the latter being most frequent today.

Purpose of the Study:

  • To review the classifications and management principles of mediastinitis.
  • To differentiate between acute and chronic forms of mediastinitis.
  • To highlight the importance of addressing primary pathology in treatment.

Main Methods:

  • Review of existing literature on mediastinitis.
  • Classification of mediastinitis into acute and chronic categories.
  • Discussion of treatment strategies based on disease type and presentation.

Main Results:

  • Mediastinitis can be acute (necrotizing, poststernotomy) or chronic (granulomatous, fibrosing).
  • Acute mediastinitis requires treatment directed at the primary pathology and clinical presentation.
  • Chronic mediastinitis management is largely palliative, with surgical intervention offering limited benefit.

Conclusions:

  • Understanding the etiology and classification of mediastinitis is crucial for effective management.
  • Prompt and appropriate treatment of acute mediastinitis is essential.
  • Chronic mediastinitis presents unique challenges with limited therapeutic options.

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