Case Reports
Descending Necrotizing Mediastinitis: Treatment by Transcervical Thoracic Drainage
A.F. Honguero Martínez
, A. Arnau Obrer, A. Fernández Centeno, R. Saumench Perramon, M. Estors, A. Cantó Armengod
Corresponding author
tonyhonguero@yahoo.es
Correspondence: Dr. A.F. Honguero Martínez. Servicio de Cirugía Torácica. Hospital General Universitario. Avda. Tres Cruces, s/n. 46014 Valencia. España
Correspondence: Dr. A.F. Honguero Martínez. Servicio de Cirugía Torácica. Hospital General Universitario. Avda. Tres Cruces, s/n. 46014 Valencia. España
Servicio de Cirugía Torácica, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
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"apellidos" => "Honguero Martínez" "email" => array:1 [ 0 => "tonyhonguero@yahoo.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Arnau Obrer" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Fernández Centeno" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "Saumench Perramon" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Estors" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Cantó Armengod" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Cirugía Torácica, Consorcio Hospital General Universitario de Valencia, Valencia, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. A.F. Honguero Martínez. Servicio de Cirugía Torácica. Hospital General Universitario. Avda. Tres Cruces, s/n. 46014 Valencia. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-06-28" "fechaAceptado" => "2004-07-24" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec154072" "palabras" => array:3 [ 0 => "Descending necrotizing mediastinitis" 1 => "Transcervical mediastinal drainage" 2 => "Peritonsillar abscess" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154073" "palabras" => array:3 [ 0 => "Mediastinitis necrosante descendente" 1 => "Drenaje mediastínico transcervical" 2 => "Absceso periamigdalino" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">We report the case of a 29-year-old man with descending necrotizing mediastinitis and subcarinal spread secondary to oropharyngeal infection. The thoracic infection was treated by placement of a transcervical thoracic drain, which was removed 15 days after surgery. The outcome was satisfactory and no further invasive treatment was required. We believe that transcervical thoracic drainage is a useful initial treatment for descending necrotizing mediastinitis with subcarinal spread but no pleural cavity involvement.</p>" ] "es" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso clínico de un varón de 29 años de edad que presentó una mediastinitis necrosante descendente con extensión infracarinal secundaria a un proceso infeccio-so orofaríngeo. La infección torácica fue tratada mediante un drenaje torácico vía transcervical, que se retiró al deci-moquinto día del postoperatorio. La evolución fue favorable sin necesidad de una reintervención más radical. Considera-mos que en la mediastinitis necrosante descendente con extensión infracarinal sin rotura pleural es útil inicialmente el tratamiento con drenaje torácico transcervical.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Descending necrotizing mediastinitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "AS Estrera" 1 => "MJ Landay" 2 => "JM Grisham" 3 => "DP Sinn" 4 => "MR Platt" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Surg Gynecol Obstet" "fecha" => "1983" "volumen" => "157" "paginaInicial" => "545" "paginaFinal" => "552" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6648776" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of descending necrotizing mediastinitis: an aggressive treatment for an aggressive disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "CH Marty-Ane" 1 => "JP Berthet" 2 => "P Alric" 3 => "JD Pegis" 4 => "P Rouviere" 5 => "H Mary" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "1999" "volumen" => "68" "paginaInicial" => "212" "paginaFinal" => "217" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10421143" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Manifestaciones clínicas y mortalidad de la mediastinitis necrosante descendente" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R Figueroa-Damian" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Invest Clin" "fecha" => "2001" "volumen" => "53" "paginaInicial" => "35" "paginaFinal" => "40" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11332049" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Análisis descriptivo de una serie de casos diagnosticados de mediastinitis aguda" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P Macrí" 1 => "MF Jiménez" 2 => "N Novoa" 3 => "G Varela" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2003" "volumen" => "39" "paginaInicial" => "428" "paginaFinal" => "430" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12975075" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Infections of the mediastinum" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "MA Razzuk" 1 => "LM Razzuk" 2 => "SJ Hoover" 3 => "T Hoover" 4 => "T Butler" 5 => "HC Urscherl" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Thoracic surgery" "paginaInicial" => "1599" "paginaFinal" => "1612" "serieFecha" => "2002" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intervenciones de urgencia en el mediastino. 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