PubMed · 5178164
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J Langlois. [Pleural drainage].. https://pubmed.ncbi.nlm.nih.gov/5178164/
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A case of descending necrotizing mediastinitis that was treated by mediastinoscopic drainage is reported. The patient was a 56-year-old diabetic woman. A hypopharyngeal abscess extended to the mediastinum through the neck. No septic condition was noted. Chest CT showed that the abscess reached 4 cm below the tracheal bifurcation. Pus was drained under direct observation by mediastinoscopy, and a drain was placed in an appropriate position. After operation, lavage was performed through the drain, and cure was achieved on the 42nd postoperative day. This technique should be considered as surgical treatment for descending necrotizing mediastinitis in the absence of serious complication such as sepsis, because it has a more reliable drainage effect than the conventional transcervical method, and because it is less invasive than thoracotomy.
A 63-year-old man was stabbed by an iron bar in the perineum. On admission, the external aspect of this wound appeared to be only a tiny hole. However, the bar had penetrated the rectum, sacrum, and lumbar spinal canal up to the third lumbar vertebral body. This patient was eventually treated with sacral wound drainage, a closure of the rectal wound, and pelvic drainage. Lumbar surgery was not performed because computed tomography (CT) and magnetic resonance imaging (MRI) did not show a progression of inflammatory changes in either the lumbar canal or perispinal hollow caused by the iron bar during the hospital stay. The clinical, CT, and MRI findings thus provided important information in the diagnosis and treatment of stab wounds.