Definition
Mediastinitis is an inflammation that affects the connective tissues of the mediastinum (middle part of the thorax).
The acute forms are more frequently due to an esophageal perforation or a median sternotomy. Chronic mediastinitis, on the other hand, is the result of tuberculosis, histoplasmosis, sarcoidosis, silicosis and other fungal infections.
Esophageal perforation can be the consequence of traumatic lesions, diverticular disease, neoplasms, presence of foreign bodies or ingestion of caustic substances. In other cases, it is due to the forced emission of vomit in the context of some eating disorders such as anorexia and bulimia (Boerhaave syndrome).
Esophageal rupture or perforation may also result from iatrogenic damage during endoscopic procedures or other instrumental maneuvers.
Mediastinitis can be a complication of the median sternotomy, a surgical technique that allows access to the structures located in the center of the chest, such as the heart and large vessels. In these cases, patients have exudation of the surgical wound or sepsis, therefore they must undergo immediate drainage, debridement and broad-spectrum parenteral antibiotic therapy.
Furthermore, acute mediastinitis can be determined by the propagation of infectious processes originating from neighboring structures (eg lung abscesses, pleural empyema and retropharyngeal abscess).
Mediastinitis is characterized by thoracic and retrosternal pain, fever and dyspnea; they involve serious complications affecting the lungs, heart and large vessels and, if not adequately treated, can develop into cardiorespiratory insufficiency.
Possible Causes * of Mediastinitis
- Nervous anorexia
- Bulimia
- Esophageal diverticula
- Ingestion of caustic substances
- Pulmonary hypertension
- Histoplasmosis
- Pleurisy
- Pneumonia
- Silicosis
- Tuberculosis
- Lung cancer
- Esophagus tumor
