Acute mediastinitis is a life-threatening complication (20 to 40 % of mortality) secondary to oropharyngeal abscesses, neck infections or oesophageal leak spreading into the mediastium. Early diagnosis and optimal therapeutic approach are crucial for patient survival. CT scanning of the cervical and thoracic area is a useful tool for diagnosis and follow-up. Treatment is based on broad-spectrum antibiotherapy, adequate surgery, mediastinal drainage, and treatment of possible organ failure. There is no surgical standardized attitude. Mini-invasive approach could be satisfactory when prompt diagnosis is established and the thoracic drainage is effective. Repeated postoperative CT scanning and close clinical and laboratory monitoring could make an additional thoracotomy a second-line procedure.
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http://dx.doi.org/10.1016/j.pneumo.2009.12.013 | DOI Listing |
Recenti Prog Med
January 2025
Fondazione Policlinico Universitario A. Gemelli Irccs, Dipartimento di Scienze di Laboratorio ed Ematologiche, Roma.
A 28-year-old woman was diagnosed with high-risk triple-expressor diffuse large B-cell lymphoma (DLBCL) (stage IV, IPI 4, CNS-IPI 5), with lymph node and extranodal involvement. The patient underwent first-line R-CHOP treatment, achieving a partial response with residual mediastinal uptake. A second-line platinum-based therapy with a transplant plan followed, resulting in stable disease; thus, she was considered refractory and started third-line therapy with CAR-T cells, receiving additional chemotherapy as bridging therapy.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Department of Interventional Cardiology, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, 490, Jesús María, 15072 Lima, Perú.
Background: Pulmonary hypertension caused by extrinsic pulmonary vascular compression secondary to mediastinal neuroendocrine tumours is a very rare condition, posing a diagnostic challenge. There is no clear consensus regarding the best treatment strategy due to the lack of clinical data, leading to poor prognoses for these patients.
Case Summary: We present the case of a 38-year-old man hospitalized with signs of pulmonary hypertension and acute heart failure.
Cureus
December 2024
Gastroenterology II, Mohammed V Military Teaching Hospital, Rabat, MAR.
Acute esophageal necrosis (AEN) is an uncommon endoscopic finding characterized by a patchy or diffuse circumferential black pigmentation of the esophageal mucosa, corresponding to ischemic necrosis. It usually presents with upper gastrointestinal bleeding and is thought to be caused by a systemic low blood flow in patients with predisposing risk factors, like advanced age and cardiovascular comorbidities. After initial hemodynamic stabilization, diagnosis is established by esophagogastroduodenoscopy (EGD) with careful biopsies and histological evaluation.
View Article and Find Full Text PDFRadiol Case Rep
March 2025
Faculty of Medicine, Arab American University of Palestine, Jenin, Palestine.
Spontaneous cervical swelling syndrome is an uncommon clinical syndrome characterized by the sudden onset of swelling in the cervical region with no identifiable cause. A 47-year-old woman with a history of Iron Deficiency Anemia presented to the emergency department (ED) complaining of an acute left neck and upper chest swelling and pressure sensation in her neck. The swelling started suddenly and was growing rapidly over several hours.
View Article and Find Full Text PDFAnn Cardiol Angeiol (Paris)
January 2025
Cardiology Department, Ibn Rochd Hospital University, Casablanca, Morocco.
Introduction: Mature teratomas, a diverse group of germ cell tumors, rarely present with complications such as rupture.
Case Presentation: We present a case of a 27-year-old male who was admitted to our hospital with acute dyspnea. A tamponade was diagnosed and the patient underwent a pericardial puncture.
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