宫颈化脓后的纵隔炎。

Revista paulista de medicina Pub Date : 1992-09-01
A S Esgaib, M C Ghefter, R de M Lyra, R B Guidugli, A L Trajano, S M Ferreira
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引用次数: 0

摘要

本研究旨在探讨头节感染性过程引起的急性纵隔炎的发病机制、临床特点、诊断及预后。5例患者中有3例出现牙源性病灶,2例出现面部病灶。其中一人在化脓性过程扩散到纵隔之前出现了路德维希心绞痛。在其他病例中,颈部筋膜间隙迅速扩张,其中两例,除纵隔外,还累及胸膜心包。3名患者因呼吸功能不全死亡,2名患者因并发症存活。宫颈化脓后纵隔炎是一种特殊而又极为严重的胸廓内感染。脓液通过颈部的筋膜间隙到达该区域,使生物体具有令人担忧的毒血症特征。这种疾病的罕见性,对其生理病理知之甚少,以及在不熟悉这种特征的非专业服务部门对患者的初始护理,都是可能延迟诊断和恶化预后的因素。
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Mediastinitis after cervical suppuration.

The objective of this study is to decode the etiopathogenesis, the clinical feature, the diagnosis and the prognosis of the acute mediastinitis resulting of infectious processes of the cephalic segment. Three out of five patients studied presented focus of dental origin and two patients presented focus in the face area. One of them presented Ludwig's Angina before the suppurative process would spread over the mediastinum. In the others, there was fast expansion through the fascial spaces of the neck and, in two of them, besides the mediastinum, there was pleuropericardial involvement. Three patients died due to respiratory insufficiency and two survived with complications. The mediastinitis after cervical suppuration is a special and extremely serious kind of endothoracic infection. The pus reaches that area through the fascial spaces of the neck, taking the organism to an alarming toxemic feature. The rarity of the disease, the little is known about its physiopathology and the initial care of the patient in non-specialized services, which are not familiarized with this type of feature, are factors that can delay the diagnosis and worsen the prognosis.

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