Mediastinitis: Symptoms and Treatment

Mediastinitis is an inflammatory process in the area of ​​mediastinal fiber. In this disease, the nerves and blood vessels are squeezed, which provoke the development of the clinical picture. If treatment is not started in time, the likelihood of a lethal outcome is high. It should be noted that this pathological process gives serious complications to the work of other body systems.



Etiology

The following factors can provoke the development of mediastinitis in the first stage:


  • injury or mechanical damage
  • as a complication after surgery
  • mechanical or ulcerative lesions in the esophagus
  • malignant tumors.

Clinicians note that a secondary disease can develop due to the ingress of bacteria, viruses into the body. In this case, a purulent process may develop.

In addition, this disease can provoke such a disease:


  1. phlegmon;
  2. sepsis
  3. sore throat;
  4. Ulcerative colitis
  5. face.

Classification

In the international classification of ICD-10, mediastinitis was given the code — J98.5.

In the form of development of an ailment is allocated:


  • lightning fast
  • Acute mediastinitis
  • chronic.

Chronic mediastinitis is characterized by frequent remissions and exacerbations, there may be the following subspecies:


  1. Aseptic, which is divided into rheumatic, posthemorrhagic, idiopathic and adiposcopic;
  2. microbial — can be specific and nonspecific.

In origin, clinicians distinguish:


  • Primary
  • secondary mediastinitis.

By the nature of inflammation:


  1. anaerobic
  2. putrefaction
  3. Purulent mediastinitis
  4. non-voiced
  5. gangrenous;
  6. Tubercular.

According to the localization criterion, clinicians define such types of ailment:


  • front-end
  • forward
  • spilled front
  • the backward;
  • the posterior one
  • downhill;
  • Spilled back;
  • total.

A little bit less, but still there is odontogenic mediastinitis. Caries is the etiology of this form of the disease. Along the way, under the influence of reduced immunity, beriberi, bad habits, fatigue and hypothermia, phlegmon on the neck begin to form.

Symptoms

The clinical picture of acute and chronic mediastinitis varies. The acute form of the disease manifests itself in the following symptoms:


  1. chills;
  2. fever;
  3. chest pain
  4. increased sweating
  5. general intoxication, which immobilizes and disturbs the patient’s consciousness;
  6. Facial swelling
  7. cyanosis of the skin;
  8. heart palpitations
  9. Decrease in blood pressure.

The chronic form has this clinical picture:





  • A hoarse voice
  • compression of the mediastinum
  • increased sweating
  • mean temperature rise;
  • weakness;
  • cough;
  • chest pain
  • shortness of breath.

As the pathological process develops, the clinical picture is exacerbated. As a result, disturbances in breathing and blood circulation begin, accompanying pathological processes develop.

Posterior mediastinitis is characterized by the following symptoms:


  1. pain in the ribs
  2. A hoarse voice
  3. cough without phlegm
  4. burning pain in the chest, which is strengthened by pressing on the processes of the thoracic vertebrae
  5. constant hiccup

Anterior mediastinitis is characterized by pain in the chest part. It is strengthened by pressing on the chest and tilting the head back. Purulent mediastinitis is similar to its clinical picture of sepsis.

In addition to the general characteristics, mediastinitis has specific symptoms by which it is possible to determine the ailment:


  • low swelling in the chest and thoracic vertebrae;
  • swelling of the clavicle and jugular cavity
  • ERW Syndrome

At the first manifestations of the clinical picture, you should immediately seek medical help.

Diagnostics

Timely diagnosis of mediastinitis will prevent complications, but it is difficult to detect the disease at an early stage of development. The doctor needs to conduct a detailed physical examination, analyze the clinical picture of the patient. The standard diagnostic program includes the following clinical activities:


  1. X-ray;
  2. Tomography
  3. esophagoscopy
  4. Bronchoscopy
  5. Ultrasound;
  6. mediastinoscopy
  7. blood test
  8. Thoracoscopy

Treatment

The doctors of the department of thoracic surgery should be engaged in treatment of this disease. Since the ailment affects all internal organs, the patient’s therapy can partially go into cardiac surgery.

If the ailment does not provoke the appearance of flagships or abscess, mediastinitis treatment will be limited to drug therapy. Typically, the doctor prescribes the following drugs:


  • antibiotics
  • Anti-inflammatory;
  • detoxification;
  • painkillers.

The doctor also prescribes immunocorrecting and symptomatic drugs. In the case of a purulent process, surgical intervention is required.

The course of treatment may include the introduction of infusion therapy to correct the protein and water-salt level in the body.

There are no specific restrictions or recommendations for nutrition. However, the patient must receive daily necessary vitamins and minerals, eat according to the regime.

Forecast

Contact mediastinitis requires immediate hospitalization of the patient. If treatment is not started in time, it is possible to develop serious complications, not an exception, a lethal outcome. Also, other forms of this disease can lead to death. If clinical events are initiated in a timely manner, there are no complications.

Prevention

Caution mediastinitis can be if:


  1. Avoid damage to the chest;
  2. use food correctly
  3. Follow all the doctor’s recommendations after the operation.




When the first manifestations of the clinical picture should immediately seek medical help.