Özofagus perforasyonuna bağlı geç tanı almış mediastinal apse

Yıl 2023, Cilt: 1 Sayı: 1, 12 - 14, 28.02.2023

Duygu Mergan İliklerden , Ufuk Çobanoğlu , Mesut Özgökçe , Görkem Kaygusuz , Metin Tan

Öz

Mediastinal apse, orofaringeal apseler, boyun enfeksiyonları veya mediastene yayılan özofagus perforasyonuna sekonder hayatı tehdit eden bir komplikasyondur. Erken tanı ve tedavi hastanın hayatta kalması için çok önemlidir. Servikal ve torasik bölgenin BT taraması tanı ve takip için yararlı bir araçtır. Tedavi, geniş spektrumlu antibiyoterapi, yeterli cerrahi, mediastinal drenaj ve olası organ yetmezliğinin tedavisine dayanır. Standart bir cerrahi tutum yoktur. 57 yaş erkek hasta 1 hafta önce kemikli et yerken göğüs ağrısı ve yutma güçlüğü, yüksek ateş şikayeti olan hastaya yapılan tetkikler sonucu mediastinal apse tespit edildi. Geniş spektrumlu antibiyoterapi başlandı. Mediastinal apse, perkütan katater ile drene edildi. Ek cerrahi bir prosedür uygulamaya gerek kalmadan hasta taburcu edildi. Mediastinal apsenin mortalitesi %20-40 arasındadır. Hızlı tanı konulduğunda ve torasik drenaj etkili olduğunda minimal invaziv yaklaşım tatmin edici olabilir.

Anahtar Kelimeler

Mediasten, Apse, Özofagus Perforasyonu, Yabancı Cisim, Drenaj, Mediastinum, Abscess, Esophageal Perforation, Foreign Body, Drainage

Late Diagnosed Mediastinal Abscess Due to Esophageal Perforation

Öz

Mediastinal abscess is a life-threatening complication secondary to oropharyngeal abscesses, neck infections, or esophageal perforation spreading to the mediastinum. Early diagnosis and treatment is very important for patient survival. CT scan of the cervical and thoracic region is a useful tool for diagnosis and follow-up. Treatment is based on broad-spectrum antibiotics, adequate surgery, mediastinal drainage, and management of possible organ failure. There is no standard surgical approach. A mediastinal abscess was detected in a 57-year-old male patient, who had chest pain, difficulty in swallowing, and high fever while eating bony meat 1 week ago. Broad spectrum antibiotics were started. Mediastinal abscess was drained with a percutaneous catheter. The patient was discharged without the need for an additional surgical procedure. Mortality of mediastinal abscess is between 20-40%. A minimally invasive approach may be satisfactory when a prompt diagnosis is made and thoracic drainage is effective.

Anahtar Kelimeler

Mediasten, Apse, Özofagus Perforasyonu, Yabancı Cisim, Drenaj, Mediastinum, Abscess, Esophageal Perforation, Foreign Body, Drainage, Mediastinum, Abscess, Esophageal Perforation, Foreign Body, Drainage

Kaynakça

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