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ECR 2019 / C-3428
Acute Mediastinitis Radiologic Diagnosis in the ER: Tips and Tricks
Congress: ECR 2019
Poster No.: C-3428
Type: Educational Exhibit
Keywords: Emergency, Head and neck, Mediastinum, CT, Conventional radiography, Diagnostic procedure, Teleradiology, Complications, Infection, Fistula, Haemorrhage
Authors: J. M. LÓPEZ ARCAS CALLEJA, M. Grande Bárez, P. Torres Rubio, G. Liaño Esteso, R. M. Lorente Ramos; Madrid/ES



Acute mediastinitis is generally described as an inflammation of the soft tissues surrounding the different structures of the mediastinum.

The aim of the following presentation is to give the general radiologist some tips and tricks to diagnose an Acute Mediastinitis in the ER. Awareness of the clinical manifestations and imaging findings is crucial for making an accurate and timely diagnosis in order to provide the patient´s best treatment.  


Although the term “Mediastinitis” reflects a general inflammation of the mediastinal soft tissues, we can identify, different subtypes of acute mediastinitis:

  • Postoperative Infection (mainly Post Cardiac Surgery, specifically if a Middle Sternotomy has been performed)
  • Esophageal perforation.
  • Extension of osteomyelitis from an adjacent bone. 
  • Descending Necrotizing mediastinitis.
  • Hematogenous Spreading. 

Less frequent causes:

  • Tracheal Perforation
  • Direct spreading from the mediastinal lymphatic nodes
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