Diagnosis of esophageal damage with the development of acute purulent mediastinitis
Keywords:esophageal perforation, mediastinitis, diagnosis of esophageal perforations
The purpose of the study: to improve the quality of diagnosis of esophageal perforations and acute purulent mediastinitis using instrumental diagnostic methods. Materials and methods. In 2000–2018, 92 patients with esophageal perforations were treated at the department of thoracic surgery of Ivano-Frankivsk Regional Hospital, 33 (35.8 %) of them were diagnosed with acute purulent mediastinitis. Results. To solve the taska, the results of the diagnosis were analyzed using chest X-ray, spiral computed tomography, esophagogram, esophagogastroduodenoscopy, fiber-optic bronchoscopy, ultrasound of the neck, upper mediastinum, pleural sinuses, heart and pericardium. Conclusions. The use of a set of instrumental researches is a decisive factor in the correct diagnosis of acute purulent mediastinitis. The most informative method for the diagnosis of acute purulent mediastinitis is spiral computed tomography with a diagnostic value of 100 %. The use of additional research methods, namely esophagogram, ultrasound, fiber-optic bronchoscopy, can confirm the diagnosis of acute purulent mediastinitis and determine the nature of complications, which is decisive in choosing further surgical treatment.
Karagyozov P, Minchev T, Tishkov I, Plachkov I. Hybrid therapy of late diagnosed esophageal perforation, complicated by mediastinitis and bilateral empyema. Endoscopy. 2017 Feb;49 (S 01):E127-E128. doi: 10.1055/s-0043-103947. Epub 2017 Mar 22.
Drobiazgin EA, Chikinev YuV, Anikina MS. Diagnistika i lecheniie pacientov s instrymentalnoy perforaciiey pichevoda. [Diagnostic and treatment patients with instrumental injuries]. Vesnik khirurhii. 2016. №4: 64-67. [In Russian]
Toru Nakano, Ko Onodera, Hirofumi Ichikawa, Takashi Kamei. Thoracoscopic primary repair with mediastinal drainage is a viable option for patients with Boerhaave’s syndrome. J Thorac Dis. 2018 Feb; 10(2): 784–789.
Shevchuk IM, Snizhko SS. Analiz uskladnen gostroho gniynogo mediastunitu. [Analisis complications of acute purulent mediastinitis]. Кlinichna khirurhiia. 2017.Jenuery (1): 36 – 38. [In Ukrainien].
Soppimath SS, Chiniwalar S, Hartimath B, Padasali P. Endoscopic mediastinal debridement for mediastinitis resulting from upper esophageal perforation. Endoscopy. 2016; 48 Suppl 1 UCTN:E168-9. doi: 10.1055/s-0042-105562. Epub 2016 Apr 29.
Markar SR, Mackenzie H, Wiggins T, Askari A, Faiz O, Zaninotto G, Hanna GB. Management and Outcomes of Esophageal Perforation: A National Study of 2,564 Patients in England. Am J Gastroenterol. 2015 Nov;110(11):1559-66. doi: 10.1038/ajg.2015.304. Epub 2015 Oct 6.
Kim JE, Ryoo SM , Kim YJ , Lee JS, Ahn S, Seo DW, Sohn CH, Ryu JM, Kim WY. Incidence and Clinical Features of Esophageal Perforation Caused by Ingested Foreign Body. Korean J Gastroenterol. 2015 Nov; 66(5):255-60. doi: 10.4166/kjg.2015.66.5.255.
Copyright (c) 2018 UKRAINIAN JOURNAL OF SURGERY
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
- The rights to the article are deemed transferred by the authors to the edition (the publisher) since the moment of the publication of the article in the printed or electronic version of journal.