Takanami I, Naruke M, Kodaira S
Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Surg Today. 1998;28(11):1200-2. doi: 10.1007/s005950050314.
Descending necrotizing mediastinitis (DNM) is a potentially life-threatening complication that can develop after an oropharyngeal infection. Patients with DNM are usually treated with mediastinal drainage through a cervical or transthoracic approach, as well as by the systemic administration of antibiotics. We report herein the cases of two patients we recently treated for DNM. In the first patient, the DNM was limited to the upper mediastinum, and cervicomediastinal drainage was performed. In the second patient, the mediastinitis spread below the tracheal bifurcation down into the lower mediastinum, and an abscess was drained through a thoracotomy approach. The principles of the surgical approach for DNM are discussed, with a brief review of the literature following these case reports.
下行性坏死性纵隔炎（DNM）是一种可能危及生命的并发症，可在口咽感染后发生。DNM患者通常通过颈部或经胸途径进行纵隔引流，并全身使用抗生素进行治疗。我们在此报告最近治疗的两例DNM患者的病例。第一例患者的DNM局限于上纵隔，进行了颈纵隔引流。第二例患者的纵隔炎蔓延至气管分叉以下，进入下纵隔，通过开胸手术引流脓肿。本文讨论了DNM手术治疗的原则，并在这些病例报告后对文献进行了简要回顾。
