20.) Diseases of the mediastinum- clinical presentation, methods of research, diagnostic approach. Flashcards
(16 cards)
What is the mediastinum?
The mediastinum houses the heart, great vessels, nerves, lymph nodes, trachea, esophagus, and thymus.
What is acute mediastinitis?
Acute mediastinitis arises from esophageal perforation or post-cardiac surgery with median sternotomy. Symptoms include severe chest pain, fever, and sepsis.
How is acute mediastinitis treated?
Esophageal perforation requires surgical exploration, repair, and drainage of the mediastinum and pleural space. Post-sternotomy mediastinitis is treated with immediate drainage, debridement, and IV antibiotics.
What causes chronic mediastinitis?
Chronic mediastinitis results from infections like tuberculosis and histoplasmosis or conditions like sarcoidosis.
What are the symptoms of chronic mediastinitis?
Granulomatous inflammation is typically asymptomatic, while fibrosing mediastinitis causes symptoms due to compression of mediastinal structures.
What are mediastinal masses?
Mediastinal masses can be benign or malignant and are often asymptomatic, discovered incidentally on chest X-rays.
What symptoms may indicate the presence of mediastinal masses?
Symptoms, when present, include cough, chest pain, and dyspnea.
What types of masses are found in the anterior mediastinum?
Includes thymomas, lymphomas, teratomas, and thyroid lesions.
What types of masses are found in the middle mediastinum?
Consists of vascular masses, enlarged lymph nodes, and bronchogenic or pleuro pericardial cysts.
What types of masses are found in the posterior mediastinum?
Contains neurogenic tumors, gastroenteric cysts, and esophageal diverticula.
What imaging methods are used in the diagnostic approach for mediastinal diseases?
CT scans are essential for evaluating the size, location, and characteristics of mediastinal masses. Barium swallow is used for assessing posterior mediastinal masses and esophageal involvement.
What biopsy procedures are used for diagnosing mediastinal diseases?
Needle biopsy, bronchoscopy, mediastinoscopy, and thoracoscopy are used for diagnosis.
What is the purpose of a needle biopsy in mediastinal diagnosis?
Needle biopsy is minimally invasive and guided by imaging.
What does bronchoscopy allow in the context of mediastinal diseases?
Bronchoscopy allows for airway-related mass sampling.
What is mediastinoscopy?
Mediastinoscopy provides surgical access to the mediastinum for biopsy.
What is thoracoscopy?
Thoracoscopy is a minimally invasive option for diagnosis and treatment.
