Material Selleckchem AZD5582 and methods In the years 1998–2010, at the Department of Thoracic Surgery, General and Oncological Surgery of the Medical University of Lodz, there were treated 44 consecutive patients with AM. The study group comprised the patients fulfilling modified criteria of mediastinitis diagnosis

worked out by Esterra et al. [17], which in the original version were related to descending necrotizing mediastinitis: (1) clinical manifestation of severe infection; (2) demonstration of AM etiological factors; (3) characteristic radiological picture of mediastanitis; (4) isolation of the pathogen in microbiological cultures from the mediastinal area; (5) intraoperative or postmortem Nutlin 3a documentation of mediastinitis. Exponents of sepsis in the form of: fever, tachycardia, hyperventilation and leucocytosis were observed in all patients. The study selleck chemical was given an approval by the institutional Ethical Review Committee (ERC). The age of the patients was from 19 to 83 years, mean age 52.5 years (median 54.5). There were 31 men, mean age 50,9 years (median 55) and 13 women,

mean age 56.4 years (median 58). Majority of them were referred to our department after earlier treatment in other centers which had an impact on the delay in diagnosis and on appropriate surgical treatment. The time of hospitalization was on the average about 3 weeks (23.84 ± 11.96 days, median 21.5). All patients were operated, 14 patients died. The total death rate was 31.82% (38.7% in male and 15.4% in female group). The etiology

of AM was extremely differentiated (Table STK38 1). Iatrogenic complications were the most frequent cause of mediastinal infection. They were found in 19 patients (43.2%) and associated with esophageal and tracheal surgeries or with injuries to these organs during endoscopy or intubation. Non-iatrogenic esophageal and tracheal injuries were the cause of AM in 11 patients (25%). This group also included perforations caused by a foreign body. Descending AM was detected in 9 patients (20.4%). In 5 patients (11.4%) AM resulted from a spontaneous perforation of advanced esophageal cancer or lung cancer with infiltration to the esophagus (neoplastic etiology).