Computed tomography of the sternum and mediastinum after median sternotomy
| Autor: | Bengt Åberg, Catarina Y. Bitkover, Kerstin Cederlund, Jarle Vaage |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Sternum medicine.medical_specialty medicine.medical_treatment Dehiscence Postoperative Complications Surgical Wound Dehiscence medicine Humans Prospective Studies Aged Retrospective Studies business.industry Mediastinum Postoperative complication Retrospective cohort study Middle Aged medicine.disease Mediastinitis Surgery Pseudarthrosis medicine.anatomical_structure Median sternotomy Female Radiology Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business Complication |
| Zdroj: | The Annals of Thoracic Surgery. 68:858-863 |
| ISSN: | 0003-4975 |
| Popis: | Background . Computed tomography is used in our hospital to diagnose complications after median sternotomy, but its efficiency is unknown. Nor is the computed tomographic appearance of normal healing of a median sternotomy known. Computed tomography was evaluated for its ability to diagnose mediastinitis and sternal dehiscence, and a reference material of normally healing median sternotomies was created. Methods . In a prospective study, 20 patients with a normally healing median sternotomy were examined 1 week, 1 month, 3 months, and 6 months after operation. In a retrospective study, 87 scans from 65 patients that were made because a postoperative complication was suspected were reviewed. Results . In the prospective study, all patients had clinically uneventful healing. None of the computed tomographic scans showed radiologic signs of healing at 3 months. At 6 months, half of the patients had healed completely. In the retrospective study, 49 scans were performed on suspicion of infection; 7 of them indicated mediastinitis, 2 were false-positive, while mediastinitis was present in a total of 16 of the scans. Thirty-eight scans were made because of sternal pain or suspected dehiscence; after 21 of the scans, recovery was uneventful, and in 11, the definite diagnosis was dehiscence or pseudarthrosis. Conclusions . Clinical healing of the sternotomy does not correlate with the computed tomographic image. Computed tomography is not a sensitive tool for diagnosing mediastinitis, and in patients with sternal pain, it adds little information. |
| Databáze: | OpenAIRE |
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