Background：Fibrosing mediastinitis （FM） is a rare disease.FM is thought to be related to prior granulomatous mediastinal infection,such as histoplasmosis or tuberculosis.The majority of cases have been reported in ...Background：Fibrosing mediastinitis （FM） is a rare disease.FM is thought to be related to prior granulomatous mediastinal infection,such as histoplasmosis or tuberculosis.The majority of cases have been reported in endemic regions for histoplasmosis.The characteristics of cases of FM in China,where the prevalence of tuberculosis is high,have not been reported.We analyzed the clinical,imaging,and bronchoscopic features of Chinese patients with FM to promote awareness of this disease.Methods：Between January 2005 and June 2015,twenty patients were diagnosed with FM in our hospital.Medical records and follow-up data were collected.Imaging and biopsy findings were reviewed by radiologists and pathologists.Results：A total of 20 patients were analyzed （8 males and 12 females）.The age ranged from 43 to 88 years with a mean age of 69.5 years.Previous or latent tuberculosis was found in 12 cases.Clinical symptoms included dyspnea （18/20）,cough （17/20）,expectoration （7/20）,and recurrent pneumonia （3/20）.Chest computed tomography scans showed a diffuse,homogeneous,soft tissue process throughout the mediastinum and hila with compression of bronchial and pulmonary vessels.Calcification was common （15/20）.Pulmonary hypertension was present in 9 of 20 cases.Diffuse black pigmentation in the bronchial mucosa was frequently seen on bronchoscopy （12/13）.The patients＇ response to antituberculosis treatment was inconsistent.Conclusions：FM in Chinese patients is most likely associated with tuberculosis.Some characteristics of FM are different from cases caused by histoplasmosis.展开更多
Acute mediastinitis is a fatal disease that usually originates from esophageal perforation and surgical infection.Rare cases of descending necrotizing mediastinitis can occur following oral cavity and pharynx infectio...Acute mediastinitis is a fatal disease that usually originates from esophageal perforation and surgical infection.Rare cases of descending necrotizing mediastinitis can occur following oral cavity and pharynx infection or can be a complication of pancreatitis.The most common thoracic complications of pancreatic disease are reactive pleural effusion and pneumonia,while rare complications include thoracic conditions,such as pancreaticopleural fistula with massive pleural effusion or hemothorax and extension of pseudocyst into the mediastinum.There have been no reports of acute mediastinitis originating from pancreatitis in South Korea.In this report,we present the case of a 50-year-old female suffering from acute mediastinitis with pleural effusion arising from recurrent pancreatitis that improved after surgical intervention.展开更多
Purpose: Descending necrotizing mediastinitis(DNM) is a lethal and acute suppurative disease. This report aimed to summarize our experience in the treatment of DNM with continuous negative pressure catheter drainage a...Purpose: Descending necrotizing mediastinitis(DNM) is a lethal and acute suppurative disease. This report aimed to summarize our experience in the treatment of DNM with continuous negative pressure catheter drainage and transnasal jejunal feeding by interventional techniques. Materials and Methods: We retrospectively analyzed relevant clinical data of patients with DNM who underwent continuous negative pressure catheter drainage and transnasal jejunal feeding. All drainage catheters and jejunal feeding tubes were inserte d by interventional techniques. Results: In total, 21 patients were diagnosed with DNM by esophagography and computed tomography(CT). Catheters for the drainage of mediastinal abscesses as well as transnasal jejunal feeding tubes were successfully placed in all patients, indicating a 100% success rate. Of all patients, 13 underwent insertion of abscess drainage catheters through percutaneous puncture under DynaCT guidance, while eight had drainage catheter insertion through fistula orifices in the posterior nasopharyngeal wall or esophagus under fluoroscopic guidance. In total, 26 drainage tubes were inserted. One patient with diabetes died of sepsis and diabetic ketoacidosis 5 days postoperatively, while the remaining 20 patients showed good recovery with successful removal of the drainage catheters. Durations of catheterization were 45.2±50.44 days. The overall clinical success rate was 95.2%. Conclusion: The above described methods are non-surgical, minimally invasive and efficacious, and may be alternative therapeutic tools for patients who are not eligible for surgical operation, have a high postoperative risk, or are more likely to choose minimally invasive techniques.展开更多
BACKGROUND We planned this study considering that complications of deep neck infections can be seriously life threatening.AIM To raise awareness that introthoracic complications and necrotizing fasciitis are causes of...BACKGROUND We planned this study considering that complications of deep neck infections can be seriously life threatening.AIM To raise awareness that introthoracic complications and necrotizing fasciitis are causes of serious mortality and morbidity.METHODS This study was carried out with the participation of 188 patients who were treated at Mersin University Department of Otorhinolaryngology and Head and Neck Surgery at January 1,2024.When the patient files were retrospectively examined,16 of 188 patients(8.5%)were included in the study because they were observed to have necrotizing fasciitis and/or intrathoracic complications.RESULTS There were a total of 16 patients in this study,9 males(56.25%)and 7 females(43.75%).All patients were adults(>18 years)and the mean age was 50.37 years±15.37 years.Female patients had a mean age of 40.42 years±13.38 years,whereas for male patients was 58.11 years±12.44 years.CONCLUSION Patients with necrotizing fasciitis and/or intrathoracic complications require more complicated and serious surgeries,intensive care unit monitoring,and mechanical ventilator support.Higher rates of morbidity and mortality should be expected in Bal KK et al.Deep neck infections mortal complications WJCC https://www.wjgnet.com 6384 October 26,2024 Volume 12 Issue 30 these patients who are hospitalized for longer periods of time.展开更多
文摘Background：Fibrosing mediastinitis （FM） is a rare disease.FM is thought to be related to prior granulomatous mediastinal infection,such as histoplasmosis or tuberculosis.The majority of cases have been reported in endemic regions for histoplasmosis.The characteristics of cases of FM in China,where the prevalence of tuberculosis is high,have not been reported.We analyzed the clinical,imaging,and bronchoscopic features of Chinese patients with FM to promote awareness of this disease.Methods：Between January 2005 and June 2015,twenty patients were diagnosed with FM in our hospital.Medical records and follow-up data were collected.Imaging and biopsy findings were reviewed by radiologists and pathologists.Results：A total of 20 patients were analyzed （8 males and 12 females）.The age ranged from 43 to 88 years with a mean age of 69.5 years.Previous or latent tuberculosis was found in 12 cases.Clinical symptoms included dyspnea （18/20）,cough （17/20）,expectoration （7/20）,and recurrent pneumonia （3/20）.Chest computed tomography scans showed a diffuse,homogeneous,soft tissue process throughout the mediastinum and hila with compression of bronchial and pulmonary vessels.Calcification was common （15/20）.Pulmonary hypertension was present in 9 of 20 cases.Diffuse black pigmentation in the bronchial mucosa was frequently seen on bronchoscopy （12/13）.The patients＇ response to antituberculosis treatment was inconsistent.Conclusions：FM in Chinese patients is most likely associated with tuberculosis.Some characteristics of FM are different from cases caused by histoplasmosis.
文摘Acute mediastinitis is a fatal disease that usually originates from esophageal perforation and surgical infection.Rare cases of descending necrotizing mediastinitis can occur following oral cavity and pharynx infection or can be a complication of pancreatitis.The most common thoracic complications of pancreatic disease are reactive pleural effusion and pneumonia,while rare complications include thoracic conditions,such as pancreaticopleural fistula with massive pleural effusion or hemothorax and extension of pseudocyst into the mediastinum.There have been no reports of acute mediastinitis originating from pancreatitis in South Korea.In this report,we present the case of a 50-year-old female suffering from acute mediastinitis with pleural effusion arising from recurrent pancreatitis that improved after surgical intervention.
文摘Purpose: Descending necrotizing mediastinitis(DNM) is a lethal and acute suppurative disease. This report aimed to summarize our experience in the treatment of DNM with continuous negative pressure catheter drainage and transnasal jejunal feeding by interventional techniques. Materials and Methods: We retrospectively analyzed relevant clinical data of patients with DNM who underwent continuous negative pressure catheter drainage and transnasal jejunal feeding. All drainage catheters and jejunal feeding tubes were inserte d by interventional techniques. Results: In total, 21 patients were diagnosed with DNM by esophagography and computed tomography(CT). Catheters for the drainage of mediastinal abscesses as well as transnasal jejunal feeding tubes were successfully placed in all patients, indicating a 100% success rate. Of all patients, 13 underwent insertion of abscess drainage catheters through percutaneous puncture under DynaCT guidance, while eight had drainage catheter insertion through fistula orifices in the posterior nasopharyngeal wall or esophagus under fluoroscopic guidance. In total, 26 drainage tubes were inserted. One patient with diabetes died of sepsis and diabetic ketoacidosis 5 days postoperatively, while the remaining 20 patients showed good recovery with successful removal of the drainage catheters. Durations of catheterization were 45.2±50.44 days. The overall clinical success rate was 95.2%. Conclusion: The above described methods are non-surgical, minimally invasive and efficacious, and may be alternative therapeutic tools for patients who are not eligible for surgical operation, have a high postoperative risk, or are more likely to choose minimally invasive techniques.
文摘BACKGROUND We planned this study considering that complications of deep neck infections can be seriously life threatening.AIM To raise awareness that introthoracic complications and necrotizing fasciitis are causes of serious mortality and morbidity.METHODS This study was carried out with the participation of 188 patients who were treated at Mersin University Department of Otorhinolaryngology and Head and Neck Surgery at January 1,2024.When the patient files were retrospectively examined,16 of 188 patients(8.5%)were included in the study because they were observed to have necrotizing fasciitis and/or intrathoracic complications.RESULTS There were a total of 16 patients in this study,9 males(56.25%)and 7 females(43.75%).All patients were adults(>18 years)and the mean age was 50.37 years±15.37 years.Female patients had a mean age of 40.42 years±13.38 years,whereas for male patients was 58.11 years±12.44 years.CONCLUSION Patients with necrotizing fasciitis and/or intrathoracic complications require more complicated and serious surgeries,intensive care unit monitoring,and mechanical ventilator support.Higher rates of morbidity and mortality should be expected in Bal KK et al.Deep neck infections mortal complications WJCC https://www.wjgnet.com 6384 October 26,2024 Volume 12 Issue 30 these patients who are hospitalized for longer periods of time.
