Mediastinal abscess
Introduction
Introduction to mediastinal abscess Mediastinal abscess refers to an abscess in the mediastinum of the lesion. Mediastinal abscess refers to an acute connective tissue purulent infection in which the staphylococcal bacteria invade the mediastinum or the blood vessels, causing necrosis and liquefaction of the tissue to form pus accumulation. Mediastinal abscess is often caused by trauma, surgery or mediastinal infection of acute connective tissue purulent inflammation. The mediastinal abscess is mostly acute connective tissue purulent inflammation caused by trauma, surgery or mediastinal infection. Tracheal and esophageal perforation caused by clinical trauma, anastomotic leakage after esophagectomy. basic knowledge The proportion of illness: 0.004% Susceptible people: no specific population Mode of infection: non-infectious Complications: Pneumothorax Shock
Cause
Cause of mediastinal abscess
Trauma (35%)
External forces such as stab wounds, car accidents, etc., if caused by chest trauma, and wounds deep into the mediastinum, Staphylococcus aureus invade tissue or blood vessels from the wound to cause necrosis and liquefaction of the diseased tissue and a localized pus accumulates to form cysts.
Bacterial infection (30%)
When the body is weak or the disease is not cured for a long time, the body's immunity is low, or the number of Staphylococcus aureus invading the body is large. When it exceeds the capacity of the body's immune system, it can cause infection, the bacteria invade the mediastinum, and the inflammatory substances enter. The mediastinum loosens the connective tissue and spreads throughout the mediastinum, eventually forming an abscess.
Prevention
Mediastinal abscess prevention
The prevention of this disease is mainly to actively treat primary diseases, especially the parapharyngeal space and the infection of the posterior pharyngeal space. Active anti-infective measures should be taken to prevent the occurrence of mediastinal abscess. Pay attention to safety in daily life and work, and prevent external trauma factors from causing chest trauma.
Complication
Mediastinal abscess complications Complications
When the mediastinal abscess forms pus, it can break into the pleural cavity to form empyema and pus pneumothorax. The gas can also subcutaneously form subcutaneous emphysema along the loose connective tissue. Patients may have difficulty breathing or even shock. The mediastinal abscess often coincides with the right upper lobe. infection.
Symptom
Mediastinal abscess symptoms Common symptoms Chest pain fever with cough, slightly... Fever fever
The patient developed symptoms such as chills, high fever, irritability, and complained of severe pain after the sternum. The pain was aggravated when breathing deep or coughing, and even narcotic analgesics could not be relieved. The pain can be radiated to the neck, behind the ear, the entire chest and the shoulders on both sides, and some can cause nerve root pain.
Localized mediastinal abscess can present compression symptoms of the surrounding organs, such as hoarseness (recurrent laryngeal nerve compression), diaphragmatic contraction weakness or paralysis (twist nerve compression), Horner syndrome (sympathetic stellate nerve) When the vagus nerve is compressed, the heartbeat can be accelerated.
After the mediastinal abscess forms pus, it can break into the pleural cavity to form empyema and pus pneumothorax. The gas can reach the subcutaneous body along the loose connective tissue, forming subcutaneous emphysema, and breathing difficulties or even shock. Mediastinal abscess often complicated with infection of the right upper lobe.
Examine
Examination of mediastinal abscess
X-ray examination is the main method for diagnosing mediastinal abscess. The plain film can be seen in the soft tissue thickening of the neck, widening of the mediastinum, pleural gas-liquid level and organ displacement, etc. The diagnosis of empyema, except for the clinical manifestations, X-ray shows pleural cavity. Liquid, CT scan can more clearly determine the location of the lesion and the extent of the lesion, and provide a more accurate basis for early diagnosis and treatment.
Diagnosis
Diagnosis and differentiation of mediastinal abscess
Need to identify the mediastinal tumor phase, especially when the tumor is completely infected, it is necessary to pay attention to the identification. The symptoms of mediastinal tumor mainly include the following:
(1) respiratory symptoms: chest tightness, chest pain usually occurs in the back of the sternum or the side of the chest, most malignant tumors invade the bones or nerves, the pain is severe, cough is often caused by pressure of the trachea or lung tissue, hemoptysis is less common.
(2) symptoms of the nervous system: due to tumor compression or erosion of the nerve to produce various symptoms: such as tumor invasion can cause hoarseness, can produce chest pain or paresthesia, causing limb paralysis.
(3) Symptoms of infection: If the cyst is broken or the tumor infection affects the bronchial or lung tissue, a series of infection symptoms appear.
(4) symptoms of compression: esophagus, tracheal compression, there may be symptoms such as shortness of breath or hypopharyngeal obstruction.
(5) Special symptoms: The patient coughs up sebum and hair.
