Purulous Post-Traumatic Mediastinitis as a Complication of Flammable Penetrating Wounds of the Breast

Abstract

Abstract. The purpose of the study. Dissemination of ideas about the peculiarities of the course of post-traumatic purulent mediastinitis, against the background of penetrating gunshot wounds of the chest for further improvement of diagnosis and treatment of this formidable complication.
 Material and methods. The study is based on the analysis of 30 observations of post-traumatic purulent mediastinitis, and 13 (32 %) of the injured were characterized by the predominance of phlegmon of the mediastinum, and in 17 (68 %) — observations of limited suppuration of the mediastinum dominated.
 Results and discussion. The average age at mediastinal phlegmon was 20 % higher compared to observations of limited mediastinal suppuration (37.2 and 44.6 years, respectively). The vast majority of the wounded were in the most working age (21–50 years): 82.8 % and 63.6 %, respectively. Abscesses were more often localized in the anterior mediastinum (33.3 %), while in case of phlegmon, tissue of the posterior mediastinum was more often involved or a total lesion of the mediastinum was observed (64.7 %). The maximum lethality (35.1 %) was observed with phlegmon of the posterior mediastinum or with a total lesion of the mediastinum, and the minimum – with abscesses of the anterior mediastinum (5.5 %).
 Conclusions. Thus, the work considered 30 cases of post-traumatic purulent mediastinitis, and 13 (32 %) of the wounded were characterized by the predominance of phlegmon of the mediastinum, and in 17 (68 %) — limited suppuration of the mediastinum dominated. All of the above indicates the need for further in-depth study of this complex and still not fully resolved problem.