Logo Medical Science Monitor

Call: +1.631.470.9640
Mon - Fri 10:00 am - 02:00 pm EST

Contact Us

Logo Medical Science Monitor Logo Medical Science Monitor Logo Medical Science Monitor

01 July 2007

A less invasive management of post-thyroidectomy descending necrotizing mediastinitis is feasible: A case report and literature review

Nikolaos D Panagopoulos, Efstratios E Apostolakis, Markos N Marangos, Efstratios N Koletsis, Petros Zampakis, Konstantinos Panagopoulos, Dimitrios Dougenis

Med Sci Monit 2007; 13(7): CS83-87 :: ID: 487399

Abstract

Background:
Descending necrotizing mediastinitis (DNM) is a life-threatening complication secondary to oropharyngeal abscesses, esophageal perforation, or neck infections spreading into the mediastium, but very uncommon after thyroidectomy. Early diagnosis and close clinical and laboratory monitoring are crucial for patient survival. CT scanning of the cervical and thoracic area is a useful tool for diagnosis and follow-up. Different surgical approaches in the management of DNM have been proposed, the most widely accepted being a combined cervicotomy with lateral thoracotomy procedure.
Case Report:
A rare case of DNM with group A ß-hemolytic streptococci, in a 47-year-old patient developing after thyroidectomy for multinodular goiter is presented. A more conservative approach through a cervical incision was followed and thoracic drains for pleural effusion evacuation were inserted. After re-operation, repeated CT scanning for disease progression and prompt surgical wound cleaning were performed. Antibiotic therapy was continued up to one month after release. The patient’s recovery was uneventful and continues well.
Conclusions:
To the best of the authors’ knowledge this is the second case of post-thyroidectomy DNM reported. According to present data it is recommend that a less invasive approach could be satisfactory when prompt diagnosis is established and the thoracic drainage is effective. This case suggests that repeated postoperative CT scanning and close clinical and laboratory monitoring could make an additional thoracotomy a second-line procedure. Moreover, due to the fact that only two cases of post-thyroidectomy DNM are reported worldwide, therapy of this condition remains an open question.

Keywords: Thyroidectomy - methods, Mediastinum - radiography, Mediastinitis - therapy, Mediastinal Diseases - radiography, Goiter, Nodular - surgery, Disease Progression, Contrast Media - pharmacology, Aorta, Thoracic - pathology, Disease Progression, Tomography, X-Ray Computed - methods, Thyroidectomy - methods, Mediastinum - radiography, Mediastinitis - therapy, Mediastinal Diseases - radiography, Goiter, Nodular - surgery, Aorta, Thoracic - pathology, Contrast Media - pharmacology

Add Comment 0 Comments

Editorial

01 May 2024 : Editorial  

Editorial: First Regulatory Approval for Adoptive Cell Therapy with Autologous Tumor-Infiltrating Lymphocytes (TILs) – Lifileucel (Amtagvi)

Dinah V. Parums

DOI: 10.12659/MSM.944927

Med Sci Monit 2024; 30:e944927

In Press

Database Analysis  

Long-Term Prognosis of Patients Undergoing Percutaneous Coronary Intervention: The Impact of Serum Creatini...

Med Sci Monit In Press; DOI: 10.12659/MSM.943063  

Database Analysis  

Maternal Exposure to Environmental Air Pollution and Premature Rupture of Membranes: Evidence from Southern...

Med Sci Monit In Press; DOI: 10.12659/MSM.943601  

Animal Research  

Enhanced Bone Healing Through Systemic Capsaicin Administration: An Experimental Study on Wistar Rats

Med Sci Monit In Press; DOI: 10.12659/MSM.942485  

Clinical Research  

Differential Inflammatory Responses in Adult and Pediatric COVID-19 Patients: Implications for Long-Term Co...

Med Sci Monit In Press; DOI: 10.12659/MSM.944052  

Most Viewed Current Articles

17 Jan 2024 : Review article  

Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron Variant

DOI :10.12659/MSM.942799

Med Sci Monit 2024; 30:e942799

0:00

14 Dec 2022 : Clinical Research  

Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase Levels

DOI :10.12659/MSM.937990

Med Sci Monit 2022; 28:e937990

0:00

16 May 2023 : Clinical Research  

Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...

DOI :10.12659/MSM.940387

Med Sci Monit 2023; 29:e940387

0:00

01 Jan 2022 : Editorial  

Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...

DOI :10.12659/MSM.935952

Med Sci Monit 2022; 28:e935952

0:00

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750