MEDIASTINITIS

inflammation of the tissue around the heart, aortic artery, and entrance (hilum) to the lungs, located in the middle chest cavity. The mediastinum is essentially the space between the left and right lung; it contains all the organs and major structures of the chest except the lungs themselves. Inflammation of the mediastinum can be caused by physical injuries, infections, or tumour growths. Most cases of acute mediastinal infection arise as complications of perforation of the esophagus. The wall of the esophagus can be penetrated by tumour growths or foreign objects, such as chicken or fish bones, glass, pins, or small toys swallowed by children. While attempts are being made to remove lodged objects, the wall can be injured by surgical instruments. Most persons with cases of mediastinitis show symptoms of severe pain under the breastbone, or sternum. The pain can radiate toward the neck or mid-back. Chills, high fever, and laboured breathing are common. Treatment of infections is with antibiotics. Cysts, abscesses, and tumours require either surgical drainage or removal.