A case of surgical treatment of neck phlegmon after gunshot wound complicated by total posterior mediastinitis using laparoscopic surgical techniques

Abstract

The purpose of this article is to demonstrate the peculiarities of diagnosis and staged surgical treatment for neck phlegmon after gunshot wound complicated by total posterior mediastinitis using laparoscopic surgical techniques. Inflammatory complications in neck injuries are a serious complication with a rapid course. An important diagnostic method is multislice computed tomography. The use of multislice computed tomography in the dynamics of the postoperative period allows for timely detection of further spread of the mediastinal inflammatory process. In the surgical treatment of neck phlegmon, it is necessary to open all fascial spaces widely and perform drainage of the upper mediastinum. Laparoscopic access is a minimal trauma with good visualization of the posterior mediastinum (middle and lower), which allows for a complete revision, sanitation, and drainage of the posterior mediastinum. To prevent a leakage of purulent contents from the mediastinal cavity into the abdominal cavity, safety drains in both hypocostal areas are placed in subdiaphragmatic spaces to the oesophageal opening.

Keywords

• gunshot wound to the neck
• neck phlegmon
• total posterior mediastinitis
• opening of neck phlegmon
• laparoscopic drainage of the posterior mediastinum