Acute Mediastinitis Secondary to Acute Exacerbation of Pancreatitis: A Surgical Case

Acute mediastinitis as a complication of acute pancreatitis or acute exacerbation of chronic pancreatitis is rare. This report presents a surgical case of acute mediastinitis secondar y to acute exacerbation of pancreatitis. A 43- y ear-old male with a histor y of chronic alcoholic pancreatitis was referred to our hospital due to back pain and heartburn. Fur-ther examination revealed the acute exacerbation of pancreatitis and acute mediastinitis, and emergenc y thoracoscopic transthoracic mediastinal abscess drainage was performed. High levels of Elastase I in the abscess fluid led to a diagno-sis of acute mediastinitis secondar y to the acute exacerbation of pancreatitis. In the event that a patient with a histor y of pancreatitis presents complaining of heartburn or other chest discomfort, we recommend attempts at an earl y diag-nosis which are guided b y the possibilit y of severe intrathoracic complications. When acute mediastinitis is confirmed, surgical drainage should be performed.