RESUMEN
Eleven survivors of bacterial mediastinitis, which followed cardiac surgery through a median sternotomy approach, underwent noninvasive cardiopulmonary evaluation to determine whether clinically apparent mediastinal fibrosis had developed. Compared to preoperative values, forced vital capacity was reduced by 9.75 percent of predicted; the greatest reduction occurred in those patients with Gram-negative mediastinitis. In one patient, an abnormal jugular venous wave form and apex cardiogram were consistent with constrictive cardiac physiology, but this was not associated with an abnormal echocardiogram or impaired functional status. In this small series, no serious abnormalities in cardiopulmonary function were detected which could be attributed to prior mediastinal infection.
Asunto(s)
Infecciones Bacterianas/fisiopatología , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Corazón/fisiopatología , Pulmón/fisiopatología , Mediastinitis/fisiopatología , Complicaciones Posoperatorias/fisiopatología , Adulto , Anciano , Infecciones Bacterianas/etiología , Ecocardiografía , Femenino , Humanos , Pulmón/diagnóstico por imagen , Masculino , Mediastinitis/etiología , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Radiografía , Pruebas de Función Respiratoria , Estudios Retrospectivos , Esternón/cirugíaRESUMEN
Based on experience with three cases of endobronchial non-Hodgkin's lymphoma and a review of cases previously reported, two patterns of lymphomatous involvement of airways are described. The Type 1 pattern is characterized by diffuse submucosal infiltrates occurring in the presence of intra- and extrathoracic lymphoma. In Type 2 cases, central airways are involved by a solitary mass in the absence of clinically apparent systemic lymphoma. The clinical-radiologic picture is characterized by signs of pneumonitis in Type 1 cases, while in Type 2 cases, signs of airway obstruction uniformly occur.