Epidemiology and treatment of secondary acute purulent mediastinitis: Specialized department experience

Currently, the problem of diagnosis and treatment of acute purulent mediastinitis remains relevant. It is due to the disease severity, lack of a unified surgical approach, prolonged patient disability, a large number of complications and high mortality. Objective. The aim of the paper is to evaluate the treatment results of patients with secondary acute purulent mediastinitis (SAPM) for further treatment improvement. Materials and Methods. The study presents an analysis of diagnostic and treatment data for 110 patients with SAPM. All patients underwent surgery. Results. Among the SAPM causes, odontogenic neck phlegmons (50.9 %), tonsillar phlegmons (36.4 %), and adenogenic phlegmons (5.5 %) are the most common ones. Satisfactory treatment results were observed in 71 patients (64.6 %), while 39 patients (35.4 %) deceased. The main causes of death were mediastinitis progression with sepsis development, multiple organ failure and pulmonary embolism. Conclusion. The main causes of secondary mediastinitis are odontogenic and tonsillar phlegmons. The mortality rate depends on the time of patient’s admission to a surgical hospital, timely and adequate surgery, the prevalence of the purulent process in the mediastinum, and patient’s age.