Acute Mediastinitis Following a Laparotomy for Small Bowel Obstruction

Abstract

Acute mediastinitis is a rare and severe life-threatening infection affecting the connective tissues that surround the vital structures of the mediastinum. The disease is most commonly a complication of cardiothoracic and esophageal surgery, esophageal perforation or secondary to upper cervical or dental infections and has a mortality rate of 12-40%. Although cases of mediastinitis secondary to cardiothoracic surgery and esophageal perforation secondary to foreign body and endoscopy have been described, in this case we describe an unusual presentation of mediastinitis in a patient who underwent a laparotomy for a small bowel obstruction and developed postoperative acute mediastinitis with a retropharyngeal and paraesophageal abscess. This case highlights the importance of early identification and management of acute mediastinitis and demonstrates that upper gastrointestinal interventions are not without risk. J Curr Surg. 2014;4(4):113-116 doi: http://dx.doi.org/10.14740/jcs252w