HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nakamori, Y. Articles by Sugimoto, H. Search for Related Content PubMed PubMed Citation Articles by Nakamori, Y. Articles by Sugimoto, H. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Conventional Open Surgery Versus Percutaneous Catheter Drainage in the Treatment of Cervical Necrotizing Fasciitis and Descending Necrotizing Mediastinitis

¹ All authors: Department of Traumatology, Osaka University Medical School, 2-15 Yamadaoka, Suita-shi, Osaka 565-0871, Japan.

View larger version (129K): [in a new window]   Fig. 1. —46-year-old man with cervical necrotizing fasciitis. Sonogram of neck shows thyroid (arrow). Hyperechoic foci reveal gas (arrowheads) between thyroid and sternothyroid muscle, which is characteristic of cervical necrotizing fasciitis.

View larger version (144K): [in a new window]   Fig. 2. —64-year-old man with cervical necrotizing fasciitis. Photograph shows neck after drainage through five catheters.

View larger version (141K): [in a new window]   Fig. 3A. —48-year-old man with cervical necrotizing fasciitis and descending necrotizing mediastinitis. CT scans obtained before drainage show infection of sublingual and parapharyngeal space (A) and placement of catheters for contrast medium injection and drainage of infected space (B).

View larger version (144K): [in a new window]   Fig. 3B. —48-year-old man with cervical necrotizing fasciitis and descending necrotizing mediastinitis. CT scans obtained before drainage show infection of sublingual and parapharyngeal space (A) and placement of catheters for contrast medium injection and drainage of infected space (B).

View larger version (89K): [in a new window]   Fig. 3C. —48-year-old man with cervical necrotizing fasciitis and descending necrotizing mediastinitis. CT scans show postdrainage neck and mediastinum including infection of posterior mediastinum (C) and catheter introduced from neck to mediastinum through retrovisceral space (D).

View larger version (90K): [in a new window]   Fig. 3D. —48-year-old man with cervical necrotizing fasciitis and descending necrotizing mediastinitis. CT scans show postdrainage neck and mediastinum including infection of posterior mediastinum (C) and catheter introduced from neck to mediastinum through retrovisceral space (D).

View larger version (130K): [in a new window]   Fig. 4A. —53-year-old man with cervical necrotizing fasciitis and descending necrotizing mediastinitis. Initial cervical and thoracic CT scans show infection descending along parapharyngeal space from sublingual space (A). Carotid sheath and subclavian space are involved in infection (B), and cervical necrotizing fasciitis progresses to anterior mediastinum (C). Scans show bilateral pleural and pericardial effusion. Patient underwent percutaneous catheter drainage immediately.

View larger version (102K): [in a new window]   Fig. 4B. —53-year-old man with cervical necrotizing fasciitis and descending necrotizing mediastinitis. Initial cervical and thoracic CT scans show infection descending along parapharyngeal space from sublingual space (A). Carotid sheath and subclavian space are involved in infection (B), and cervical necrotizing fasciitis progresses to anterior mediastinum (C). Scans show bilateral pleural and pericardial effusion. Patient underwent percutaneous catheter drainage immediately.

View larger version (117K): [in a new window]   Fig. 4C. —53-year-old man with cervical necrotizing fasciitis and descending necrotizing mediastinitis. Initial cervical and thoracic CT scans show infection descending along parapharyngeal space from sublingual space (A). Carotid sheath and subclavian space are involved in infection (B), and cervical necrotizing fasciitis progresses to anterior mediastinum (C). Scans show bilateral pleural and pericardial effusion. Patient underwent percutaneous catheter drainage immediately.

View larger version (126K): [in a new window]   Fig. 4D. —53-year-old man with cervical necrotizing fasciitis and descending necrotizing mediastinitis. Neck radiograph shows five catheters: 1, straight catheter to sublingual space from left side of neck; 2, pigtail catheter to left parapharyngeal space from anterior of neck; 3, pigtail catheter to right parapharyngeal space from right side; 4, pigtail catheter to subclavian space; 5, straight catheter to upper anterior mediastinum from right side of neck.

View larger version (145K): [in a new window]   Fig. 4E. —53-year-old man with cervical necrotizing fasciitis and descending necrotizing mediastinitis. Chest radiograph obtained on hospital day 7 shows chest tubes for bilateral drainage of thoracic cavity. Additional pigtail catheter, 6, is inserted from anterior chest wall to residual infected space of anterior mediastinum.

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati