Infectious mediastinitis after cardiovascular surgery. Role of computed tomography

The aim of this study was to evaluate the effectiveness of computed tomography (CT) findings in the diagnosis of mediastinitis after cardiovascular surgery with median sternotomy. A total of 122 patients were divided into two groups: the early group (≤21 days after surgery) and the late group (>21 days after surgery). Among them, six patients were ultimately diagnosed with infectious mediastinitis. CT findings in each patient were evaluated. Mediastinal fluid collections or free gas bubbles were regarded as the primary findings of mediastinitis. In the early group, sensitivity and specificity of the primary CT findings were 100% and 39%, respectively. In the late group, the sensitivity was 100% and the specificity 85%. Mediastinal fluid collections were observed in all six patients with mediastinitis. Mediastinal fluid collections or free gas bubbles are not specific during the early postoperative period. However, after 21 days, these observations could be indicative of mediastinitis. (author)