Médiastinites postchirurgicales : diagnostic et traitement

Abstract

Mediastinal infection is a life-threatening complication observed after cardiac surgery or esophageal surgery, most commonly in cardiac surgery with an incidence of 0.15% to 8%. Even today the mortality remains as high as 50% when left diagnosed and treated lately. Septic chock is the most usual clinical presentation. Chest X-ray, thorax CT scanning, eso-gastroduodenal transit are essential investigations for accurate diagnosis. The treatment of mediastinitis ranges from aggressive antibiotic treatment, to local debridement of wound or surgical drainage associated with plastic surgery or to total sternal resection and reconstruction with flaps.