Successful thoracoscopic debridement of descending necrotizing mediastinitis Noritaka Isowa, MD, Tetsu Yamada, MD, Takeshi Kijima, DDS, Kazuki Hasegawa,

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Presentation transcript:

Successful thoracoscopic debridement of descending necrotizing mediastinitis Noritaka Isowa, MD, Tetsu Yamada, MD, Takeshi Kijima, DDS, Kazuki Hasegawa, DDS, Koji Chihara, MD The Annals of Thoracic Surgery Volume 77, Issue 5, Pages 1834-1837 (May 2004) DOI: 10.1016/S0003-4975(03)01260-8

Fig 1 Cervicothoracic computed tomographic scan on admission showed pharyngeal (top) and mediastinal (bottom) abscess. The Annals of Thoracic Surgery 2004 77, 1834-1837DOI: (10.1016/S0003-4975(03)01260-8)

Fig 2 Cervicothoracic computed tomographic scan 1 day after transcervical drainage was performed showed satisfying drainage in cervical lesion (top). Note the abscess is left in the right paratracheal area (bottom). The Annals of Thoracic Surgery 2004 77, 1834-1837DOI: (10.1016/S0003-4975(03)01260-8)

Fig 3 (A) Right thoracoscopic view revealed a bulged mediastinal abscess after peeling off the pleural adhesion. (B) By incising the cavity wall by cautery, the pus was spilled out. (C) The pus and necrotic tissue were removed from the paratracheal area. (Tr = trachea.) The Annals of Thoracic Surgery 2004 77, 1834-1837DOI: (10.1016/S0003-4975(03)01260-8)

Fig 4 (A) Chest computed tomographic scan showed the paratracheal abscess was quickly resolved until 3 days after the thoracoscopic surgery. (B) Anterior mediastinal abscess was resolved until 15 days after the thoracoscopic surgery. (C) Nearly normal mediastinal structure was demonstrated on postoperative day 45. The Annals of Thoracic Surgery 2004 77, 1834-1837DOI: (10.1016/S0003-4975(03)01260-8)