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Severe Mediastinal Abscess After Endobronchial Ultrasound with Transbronchial Needle Aspiration
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A6437 - Severe Mediastinal Abscess After Endobronchial Ultrasound with Transbronchial Needle Aspiration
Author Block: J. Dai; Department of Respiratory Medicine, Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University, Naijing, China.
Endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive and safe technique which is universally accepted for the mediastinum and/or hilum lymph node biopsy. Severe infectious complications following EBUS-TBNA were occasional, but sometimes life-threatening. One patient with severe mediastinal abscess after EBUS-TBNA was treated successfully with surgical drainage in our department, and we reported here to improve our clinical vigilance to this disease. The patient was a 52 years old Chinese man who denied any chronic disease histories. In his yearly routine medical examination, Chest CT (August 04, 2016) revealed a cystic mass in posterior mediastinum. EBUS-TBNA was performed to puncture the subcarinal lymph node (#7) on August 17th, 2016. Pathological examination of EBUS-TBNA specimens showed some cellulose-like degeneration materials and no malignant or granulomatous findings. The diagnosis was mediastinal cysts. The patients experienced chest pain, a slight fever and had an episode of syncope after 25 days from the EBUS-TBNA (August 29th, 2016). He returned to our hospital and was admitted in cardiological care unit (CCU) with initially diagnosis of acute coronary syndrome (ACS). Blood examinations showed us increased WBC, CRP and erythrocytes rate (ESR). Echocardiography showed moderate pericardial effusion. Chest CT (August 29th, 2016) demonstrated a mass in posterior mediastinum with moderate pericardial effusion and bilateral pleural effussion. Based on the above symptoms and examinations, acute pericarditis and mediastinal abscess were considered. Under general anesthesia and extracorporeal circuiation, pericardial fenestration was performed using thoracoscopy and about 800ml of pus was drained. Intravenous cephalosporin was administered for one more week after the operation, and chest CT ( September 6th, 2016) was rerun and demonstrated a cystic mass in posterior mediastinum without pericardial and bilateral pleural effusion. The patient recovered and discharged after then.
Author Block: J. Dai; Department of Respiratory Medicine, Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University, Naijing, China.
Endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive and safe technique which is universally accepted for the mediastinum and/or hilum lymph node biopsy. Severe infectious complications following EBUS-TBNA were occasional, but sometimes life-threatening. One patient with severe mediastinal abscess after EBUS-TBNA was treated successfully with surgical drainage in our department, and we reported here to improve our clinical vigilance to this disease. The patient was a 52 years old Chinese man who denied any chronic disease histories. In his yearly routine medical examination, Chest CT (August 04, 2016) revealed a cystic mass in posterior mediastinum. EBUS-TBNA was performed to puncture the subcarinal lymph node (#7) on August 17th, 2016. Pathological examination of EBUS-TBNA specimens showed some cellulose-like degeneration materials and no malignant or granulomatous findings. The diagnosis was mediastinal cysts. The patients experienced chest pain, a slight fever and had an episode of syncope after 25 days from the EBUS-TBNA (August 29th, 2016). He returned to our hospital and was admitted in cardiological care unit (CCU) with initially diagnosis of acute coronary syndrome (ACS). Blood examinations showed us increased WBC, CRP and erythrocytes rate (ESR). Echocardiography showed moderate pericardial effusion. Chest CT (August 29th, 2016) demonstrated a mass in posterior mediastinum with moderate pericardial effusion and bilateral pleural effussion. Based on the above symptoms and examinations, acute pericarditis and mediastinal abscess were considered. Under general anesthesia and extracorporeal circuiation, pericardial fenestration was performed using thoracoscopy and about 800ml of pus was drained. Intravenous cephalosporin was administered for one more week after the operation, and chest CT ( September 6th, 2016) was rerun and demonstrated a cystic mass in posterior mediastinum without pericardial and bilateral pleural effusion. The patient recovered and discharged after then.
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