Thorac Cardiovasc Surg 1999; 47(5): 333-335
DOI: 10.1055/s-2007-1013168
Case Report

© Georg Thieme Verlag Stuttgart · New York

Descending Necrotizing Mediastinitis: Mediastinal Drainage With or Without Thoracotomy

J. T. Kim1 , K. H. Kim1 , S. W. Lee1 , K. Sun2
  • 1Department of Thoracic and Cardiovascular Surgery, Inha University Hospital, Inchon, Korea
  • 2Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University, Seoul, Korea
Further Information

Publication History


Publication Date:
19 March 2008 (online)


Descending necrotizing mediastinitis (DNM) is a lethal process originating from odontogenic, pharyngeal, or cervical infections that descends along the fascial planes into the mediastinum. The surgical management ranges from cervical drainage to routine thoracotomy but remains controversial. We here describe two patients treated successfully who underwent cervical drainage alone or cervical drainage combined with thoracotomy. Wide cervical exploration with postural drainage was effective in one patient with limited DNM above the carina. Mediastinal exploration through thoracotomy was required to salvage the other with DNM extending below the carina and associated with pericardial invasion.