Mediastinitis: Klinik und Behandlungsoptionen

Zusammenfassung

Die akute Infektion des Mediastinums ist eine Erkrankung mit nach wie vor hoher Morbidität und Letalität. Erkrankungsmanifestation und -verlauf variieren stark in Abhängigkeit von der Infektursache. Eine meist unspezifische klinische Symptomatik sowie fehlende Kenntnis oder Sensibilität für die Erkrankung verzögern häufig die Diagnosestellung und somit den Beginn einer adäquaten Therapie. Die Computertomografie (CT) von Hals und Thorax ist die Methode der Wahl für Diagnostik und Kontrolle des Therapieerfolgs. Prognostisch entscheidend sind eine rasche Diagnosestellung mit sofortigem chirurgischen Débridement und Dränage aller infizierten Gewebekompartimente sowie eine konsequente Sepsistherapie.

Abstract

Acute infection of the mediastinum remains a condition with high morbidity and lethality rates. The manifestation and course of the illness vary widely depending on the cause of infection. Lack of knowledge or awareness of the illness and mostly unspecific clinical symptoms often delay diagnosis and thereby the start of adequate therapy. Computed tomography (CT) of the neck and thorax is the method of choice for diagnostics and control of therapeutic success. An early diagnosis with immediate surgical debridement and drainage of all infected tissue compartments, as well as strict sepsis therapy, are decisive for the prognosis.

Schlüsselwörter

Mediastinitis - deszendierende nekrotisierende Mediastinitis - akute Mediastinalinfektion - Thorakoskopie - Thorakotomie

Key words

mediastinitis - descending necrotizing mediastinitis - acute mediastinal infection - thoracoscopy - thoracotomy

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