Hernández AJA, Guerrero AG

Language: Spanish
References: 21
Page: 167-173
PDF size: 371.50 Kb.

ABSTRACT

Introduction. The incidence of deep infections of the neck has fallen as a result of opportune antimicrobial and surgical treatments. Notwithstanding, it should not be forgotten that such conditions can be life threatening, either due to loss of control of the airway or the creation of sepsis and septic shock which can cause death. Timely diagnosis is decisive to improve the patient’s evolution. The origin of such infections is variable but the most common cause is odontogenic. Also, mediastinal extension is among the uncommon, but fatal, complications. The need for timely and rapid diagnosis is elemental to treatment.
Material and methods. The modality of choice is computed tomography; however, the use of chest teleradiography as part of the diagnosis (and even as the only modality available in some cases) has been largely abandoned and its value has diminished in emergency wards. Consequently, this study examines its usefulness in comparison with computed tomography as part of the diagnostic protocol for mediastinitis secondary to deep abscess of the neck with clinical suspicion in 30 patients at Hospital General de Mexico.
Discussion. In all the cases radiological findings were reported, but the most common was mediastinal widening; however, its association with pneumomediastinum is the most relevant datum for diagnosing mediastinal extension, being most common in the upper and anterior mediastina.
Conclusion. Chest teleradiography is a tool that overdiagnoses mediastinal extension but rules out its existence in the absence of radiological signs. Therefore, it has significant usefulness for decision making in the emergency ward when other diagnostic modalities are unavailable for reasons of time, clinical or anthropometric conditions, or lack of infrastructure resources.

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