In spite of advances in the management of mediastinitis following sternotomy,mediastinitis is still associated with significant morbidity.The prognosis is much better in pediatric surgery compared to adult surgery,but...In spite of advances in the management of mediastinitis following sternotomy,mediastinitis is still associated with significant morbidity.The prognosis is much better in pediatric surgery compared to adult surgery,but the prolonged hospital stays with intravenous therapy and frequent required dressing changes that occur with several therapeutic approaches are poorly tolerated.Prevention includes nasal decontamination,skin preparation,antibioprophylaxis and air filtration in the operating theater.The expertise of the surgical team is an additional factor that is difficult to assess precisely.Diagnosis is often very simple,being made on the basis of a septic state with wound modification,while retrosternal puncture and CT scan are rarely useful.Treatment of mediastinitis following sternotomy is always a combination of surgical debridement and antibiotic therapy.Continued use of numerous surgical techniques demonstrates that there is no consensus and the best treatment has yet to be determined.However,we suggest that a primary sternal closure is the best surgical option for pediatric patients.We propose a simple technique with high-vacuum Redon's catheter drainage that allows early mobilization and short term antibiotherapy,which thus decreases physiological and psychological trauma for patients and families.We have demonstrated the ef-ficiency of this technique,which is also cost-effective by decreasing intensive care and hospital stay durations,in a large group of patients.展开更多
Mediastinal pancreatic pseudocyst(MPP)is a rare,but known,complication of both acute and chronic pancreatitis.Most pseudocysts are associated with alcoholic pancreatitis.Recent advances in endoscopic techniques have s...Mediastinal pancreatic pseudocyst(MPP)is a rare,but known,complication of both acute and chronic pancreatitis.Most pseudocysts are associated with alcoholic pancreatitis.Recent advances in endoscopic techniques have shown promising results,with reduced chances of infection and recurrence than with percutaneous drainage,but limited availability restricts widespread use.Left gastric artery pseudoaneurysm with mediastinal pseudocyst has not been described in the literature to date.We report a successful resolution of hemorrhagic MPP with embolization of pseudoaneurysm and percutaneous trans-hepatic pseudocyst drainage.展开更多
文摘In spite of advances in the management of mediastinitis following sternotomy,mediastinitis is still associated with significant morbidity.The prognosis is much better in pediatric surgery compared to adult surgery,but the prolonged hospital stays with intravenous therapy and frequent required dressing changes that occur with several therapeutic approaches are poorly tolerated.Prevention includes nasal decontamination,skin preparation,antibioprophylaxis and air filtration in the operating theater.The expertise of the surgical team is an additional factor that is difficult to assess precisely.Diagnosis is often very simple,being made on the basis of a septic state with wound modification,while retrosternal puncture and CT scan are rarely useful.Treatment of mediastinitis following sternotomy is always a combination of surgical debridement and antibiotic therapy.Continued use of numerous surgical techniques demonstrates that there is no consensus and the best treatment has yet to be determined.However,we suggest that a primary sternal closure is the best surgical option for pediatric patients.We propose a simple technique with high-vacuum Redon's catheter drainage that allows early mobilization and short term antibiotherapy,which thus decreases physiological and psychological trauma for patients and families.We have demonstrated the ef-ficiency of this technique,which is also cost-effective by decreasing intensive care and hospital stay durations,in a large group of patients.
文摘Mediastinal pancreatic pseudocyst(MPP)is a rare,but known,complication of both acute and chronic pancreatitis.Most pseudocysts are associated with alcoholic pancreatitis.Recent advances in endoscopic techniques have shown promising results,with reduced chances of infection and recurrence than with percutaneous drainage,but limited availability restricts widespread use.Left gastric artery pseudoaneurysm with mediastinal pseudocyst has not been described in the literature to date.We report a successful resolution of hemorrhagic MPP with embolization of pseudoaneurysm and percutaneous trans-hepatic pseudocyst drainage.
