Diagnosis of esophageal damage with the development of acute purulent mediastinitis

Abstract

The purpose of the study: to improve the quality of diagnosis of esophageal perforations and acute purulent mediastinitis using instrumental diagnostic methods. Materials and methods. In 2000–2018, 92 patients with esophageal perforations were treated at the department of thoracic surgery of Ivano-Frankivsk Regional Hospital, 33 (35.8 %) of them were diagnosed with acute purulent mediastinitis. Results. To solve the taska, the results of the diagnosis were analyzed using chest X-ray, spiral computed tomography, esophagogram, esophagogastroduodenoscopy, fiber-optic bronchoscopy, ultrasound of the neck, upper mediastinum, pleural sinuses, heart and pericardium. Conclusions. The use of a set of instrumental researches is a decisive factor in the correct diagnosis of acute purulent mediastinitis. The most informative method for the diagnosis of acute purulent mediastinitis is spiral computed tomography with a diagnostic value of 100 %. The use of additional research methods, namely esophagogram, ultrasound, fiber-optic bronchoscopy, can confirm the diagnosis of acute purulent mediastinitis and determine the nature of complications, which is decisive in cho­osing further surgical treatment.