Learning objectives
The aims of this exhibi were:
To review the mediastinum anatomy and deep cervical fascia,
to understand the different etiologicalprocesses of mediastinitis.
To describe the findings of acute mediastinitis in conventional radiology,
and specially in CT-scan,throughcases example.
Background
The mediastinum can be divided into three parts: anterior,
middle and posterior compartment.
There are not true anatomic tissue plane between thisthree compartments,
in free communication with one another.
The anterior mediastinum contains the following structures: thymus,
lymph nodes,
ascending aorta,
pulmonary artery,
phrenic nerves and thyroid.
The middle mediastinum contains lymph nodes,
trachea,
esophagus,azygosvein,
venacavae,
posterior heart and the aortic arch.The posterior mediastinum contains sympathetic ganglia,
nerve roots,
lymph nodes,
parasympathetic chain,thoracicduct,
descending thoracic aorta,
small vessels and the vertebrae.
The different compartments of...
Findings and procedure details
Acutemediastinitisrefers to inflammation of the tissues that surround themediastinal structures.
According to their most frequent etiology,
it can be divided into three entities: postoperative,
esophageal perforation and descending necrotizingmediastintis.
Mediatinitissuspicion is based on various clinical criteria: chest pain,
fever-sepsis,
purulent secretion from the sternal injury for postoperative patients,leucocytosisor neck swelling.
The initial radiological test includes radiographic studies.
Radiological findings in conventional radiology can guide us and confirm the suspicion ofmediastinitis,
and include the widening of the mediastinum,neumomediastino,aditionalpleural findings,
soft tissue mass,
air-fluid level (Fig 1...
Conclusion
The diagnostic confirmation by CT of mediastinitis suspicion is very importantto preventmorbidity andmortalityoflate diagnosis.So it is essential toknow the different charasterictic signs of acute mediastinitis and its causes.
References
- Del Cura JL.
Radiologia esencial.
1a edición.
Madrid: Editorial Panamericana; 2010.
- Lange S.
Radiology of Chest Diseases.
3rd edition.
New York.Thiemr Medical Publishers; 2005.
- Exharhos DN.
Acute mediastinitis: spectrum of computed tomography findings.
European Radiology.
2005; 15: 1569-1574.