Use of computed tomography to assess mediastinal complications after median sternotomy. Ann Thorac Surg 1983 Dec;36(6):706-14
Date
12/01/1983Pubmed ID
6651381DOI
10.1016/s0003-4975(10)60283-4Scopus ID
2-s2.0-0021042502 (requires institutional sign-in at Scopus site) 32 CitationsAbstract
Thirty computed tomographic (CT) scans from 27 patients who had undergone median sternotomy were reviewed. A control group of 15 asymptomatic patients was studied either early (within 21 days) or late (46 days to 22 years) after sternotomy. Twelve patients with symptoms ranging from sternal click to obvious mediastinitis also were studied within 30 days of sternotomy. The CT findings were correlated with the patient's clinical course. Imperfect sternal closure (sternal step-offs and gaps) was found in 10 of the 15 asymptomatic patients. Focal retrosternal fluid collections, air, and hematomas were seen in more than 75% of the asymptomatic patients. Retrosternal abscess, presternal abscess, and sternal disruption were noted in 3 symptomatic patients. Computed tomography correctly diagnosed the extent of mediastinal abscess in all patients. In the 3 patients in whom there was a discrepancy between the CT scan and the clinical findings, the scan ultimately was shown to be correct. These results indicate that computed tomography is a valuable tool in diagnosing wound problems after sternotomy because it accurately depicts the extent and depth of the wound infection.
Author List
Kay HR, Goodman LR, Teplick SK, Mundth EDMESH terms used to index this publication - Major topics in bold
AdultHumans
Mediastinitis
Middle Aged
Sternum
Surgical Wound Infection
Tomography, X-Ray Computed