ABSTRACT
Objective:To explore the diagnosis, treatment and curative effect of cervical cellulitis combineing mediastinal pleural abscess. Method:Clinical data of 37 patients with the cervical cellulitis and mediastinal pleural abscess were analyzed, all patients were confirmed using ultrasond, X-ray, CT, puncture and microbiology examination. The result will analysis the diagnosis, treatment and curative effect through the comparison of conservative treatment and surgical treatment. Result:Twenty-three cases of patients were underwent tracheotomy because of difficulty in breathing and successfully extubated after treatment. Nine cases of patients were given anti-infection treatment and recovered after conservative treatment. Twenty-one cases of neck multiple pus cavity were underwent cavity incision, full removal of necrotic tissue and pipe flushing; 7 cases of patients with neck and mediastinal abscess and within which 2 cases were with toxic shock were underwent adequate drainage of lavage and abscess incision through jugular joint path; the companion of pyothorax in 2 cases were underwent the chest closed drainage. All patients were giving sensitive antibiotic after drug sensitive test, anti-shock treatment and supportive treatment. All the patients were recovered and discharged. The average hospitalization days with conservative treatment of these patients were 15.7 days, and the average hospitalization days with surgical treatment of patients were 25.3 days. Conclusion:The condition of cervical cellulitis is complex, a few case can be cured with conservative treatment. The others progress rapidly when merging mediastinal pleural abscess can cause serious complications, surgical treatment is risky, fully abscess incision, lavage drainage and combine with sensitive antibiotics and supportive treatment are the keys to therapy.
ABSTRACT
Here, we present the case of a 78-year-old man with a deep neck infection that caused descending necrotizing mediastinitis that extended from the pharynx to the stomach and was accompanied by two large esophageal fistulas and multiple gastric ulcers. We believe that the series of lesions were the signs of a hidden carcinoma.
ABSTRACT
Here, we present the case of a 78-year-old man with a deep neck infection that caused descending necrotizing mediastinitis that extended from the pharynx to the stomach and was accompanied by two large esophageal fistulas and multiple gastric ulcers. We believe that the series of lesions were the signs of a hidden carcinoma.<br>
ABSTRACT
This is a retrospective study on the Ludwig's angina patients treated in Dept of Oral and Maxillofacial Surgery of Pusan National University Hospital for the period of Jan. 1985 to March 1996. The used materials of this study were 30 in total, including 18 male patients, 12 female patients. The author analyzed the distribution and incidence of sex, age, etiologic factor, pus culture, involved systemic disease, treatment methods, mortality rate. The results were as follows; 1. The incidences was higher in sixth decades(26.7%) and prevalent in male. 2. The most cause was odontogenic(83.3%) and in 15 cases(50%), the symptom aggravated after dental treatment. 3. The causative organism isolated from pus culture were Streptococci (40.7%), Staphylococci(22.2%), Bacteroid(14.8%), Candida(11.1%), Pseudomonas(3.7%), Pneumococci(3.7%), Salmonella(3.7%). 4. The patients with systemic disease were 66.7%, involved disease were DM(25%), malnutrition(22.7%), rheumatoid arthritis(11.4%), pulmonary disease(11.4%), hypertension(11.4%). 5. In all patients, surgical I&D was done, and 5 cases(16.7%) required tracheostomy. 6. In all patients, we used combination antibiotics, and the most commonly used antibiotics in the treatment were combination of Penicillin, Cephalosporin and Aminiglycoside(46.7%), and combination of Cephalosporin, Aminiglycoside and Metronidazole(30%). 7. The mortality rate was 6.7%.