Spontaneous mediastinitis with multiple esophageal abscess in the esophagus

Almorza, Tomás; Herrera-Juárez, Mercedes; Lalueza, Antonio

doi:10.1016/j.rmcr.2018.09.003

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…Oesophageal perforation generally occurs in areas of physiologic narrowing, for example, in the cricopharyngeal muscle or oesophagogastric junction. Most oesophageal perforations are iatrogenic (50–75%) and most of them occur during endoscopic procedures [14,15]. The incidence of perforation in case of simple endoscopy is <0.5% but may increase to 6% in the case of endoscope-guided pneumatic dilation to treat achalasia [16].…”

Section: Epidemiologymentioning

confidence: 99%

Sepsis in Acute Mediastinitis – A Severe Complication after Oesophageal Perforations. A Review of the Literature

Mureşan

Mureșan

Balmos

et al. 2018

The Journal of Critical Care Medicine

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Background Despite recent advancements in antibiotic therapy and the progress made in critical care and modern diagnostic methods, acute mediastinitis continues to be a severe condition. Diagnosis and treatment Acute mediastinitis can occur in the context of cardio-thoracic surgery, oesophageal perforations and oropharyngeal infections condition. Forty-five percent of oesophageal perforations occurs during simple endoscopy. Spontaneous perforation (Boerhaave syndrome) accounts for 15% of perforations, and twelve percent are due to the ingestion of foreign bodies. Other causes include blind or penetrating trauma, and circa 9% to intraoperative lesions. CT scan is the standard investigation that reveals direct signs of mediastinitis. The oral administration of contrast substances can underscore the level of oesophageal perforation. Conservative treatment is the first-choice treatment and surgical treatment is reserved only for specific situations. The principles of surgical treatment consist of drainage, primary suture, oesophageal exclusion with or without the application of oesophagectomy, endoscopic vacuum wound assisted therapy of the perforation and associated paraoesophageal mediastinal drainage and endoscopic stenting associated with drainage. Conclusions The lowest mortality rate is recorded in patients with perforations diagnosed less than twenty-four hours after the onset of symptoms. Surgical treatment remains the gold standard especially in cases of thoracic and abdominal perforations while further investigations are mandatory before endoscopic stenting is carried out.

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Section: Epidemiologymentioning

confidence: 99%

Sepsis in Acute Mediastinitis – A Severe Complication after Oesophageal Perforations. A Review of the Literature

Mureşan

Mureșan

Balmos

et al. 2018

The Journal of Critical Care Medicine

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We Should Pay Attention to "Referred Pain" - A Case of Acute Myocardial Infarction That Masked and Delayed the Diagnosis of Esophageal Perforation

et al. 2022

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We herein report a 93-year-old woman diagnosed with acute myocardial infarction (AMI) based on typical laboratory findings of severe chest pain accompanied by throat pain. This condition was initially interpreted as referred pain of cardiac origin. However, the patient had persistent throat pain after successful percutaneous coronary intervention. Upper esophageal perforation with life-threatening acute mediastinitis was unexpectedly identified by a further examination. Clinicians should have a high index of suspicion in cases with persistent symptoms thought to be referred pain among AMI patients, as these symptoms may not be of cardiac origin but rather a sign of another concomitant critical disease.

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Spontaneous mediastinitis with multiple esophageal abscess in the esophagus

Abstract: Acute mediastinitis (AM) is a rare and deadly disease without appropriate treatment. It is usually due to invasive medical procedures, being uncommon the spontaneous onset. We report a case of 49-year-old patient whose starting symptoms were dyspnea and oppressive epigastric pain.

Cited by 2 publications

References 9 publications

Sepsis in Acute Mediastinitis – A Severe Complication after Oesophageal Perforations. A Review of the Literature

Sepsis in Acute Mediastinitis – A Severe Complication after Oesophageal Perforations. A Review of the Literature

We Should Pay Attention to "Referred Pain" - A Case of Acute Myocardial Infarction That Masked and Delayed the Diagnosis of Esophageal Perforation

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