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Updated: Mar 21, 2026
06:59
Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
Published on: August 26, 2025
704
[Acute and chronic mediastinitis]
1Klinik für Thoraxchirurgie und thorakale Endoskopie, Helios Klinikum Erfurt, Nordhäuser Str. 74, 99089, Erfurt, Deutschland. joerg-kluge@helios-kliniken.de.
Summary
Acute mediastinitis, often from esophageal or tracheal perforation, requires prompt diagnosis and therapy. Descending necrotizing mediastinitis (DNM) is a severe sepsis-like infection with high mortality, while chronic mediastinitis is rare and may involve fungal links.
Area of Science:
- Thoracic surgery
- Infectious diseases
- Gastroenterology
Background:
- Acute mediastinitis necessitates a systematic approach for effective diagnosis and treatment.
- Chronic mediastinitis is an infrequent clinical occurrence.
Purpose of the Study:
- To review the etiology, clinical presentation, and management of acute and chronic mediastinitis.
- To highlight the diagnostic challenges and prognostic factors associated with mediastinal infections.
Main Methods:
- A selective literature search was conducted to gather relevant studies on mediastinitis.
Main Results:
- Acute mediastinitis commonly follows esophageal or tracheal perforation (iatrogenic) or presents as descending necrotizing mediastinitis (DNM) from oropharyngeal infections.
- Esophageal injuries have a 12% mortality rate; DNM, a severe sepsis manifestation, carries a 14% mortality rate.
- Chronic mediastinitis, a rare condition with unclear pathogenesis possibly linked to Histoplasma capsulatum, has a good prognosis.
Conclusions:
- Perforation of the esophagus or trachea poses a significant risk of mediastinal infection, mandating early diagnosis and treatment.
- DNM can present with non-specific sepsis symptoms, underscoring the need for vigilance regarding oropharyngeal infection sources.
- Chronic mediastinitis requires histological examination for accurate diagnosis, differentiating it from malignant conditions.
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