PMC10027923_01
Chest computed tomography (CT) and fluoroscopy. (A) CT showed the bronchus communicate with mediastinal abscess. Long arrow: right inferior bronchus. Short arrow: mediastinum. (B) Dimeglumine flowed into right low lobe via mediastinal drainage tube through right inferior bronchus in chest fluoroscopy. Arrow: dimeglumine. (C,D) CT and fluoroscopy (pulled dimeglumine via mediastinal drainage tube) showed the fistula of bronchus is healed. (E) CT showed mediastinal abscess was healed after oral dimeglumine. Arrow: sinus tract after removing mediastinal drainage tube.
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F1
CT and chest fluoroscopy (dimeglumine) confirmed mediastinal abscess and right lower lobar bronchus fistula (Figure 1A,B). Temperature and WBC recovered soon afterwards, and the cough gradually improved. 6 days later, BEF was healed (Figure 1C,D), and then mediastinal decompression drainage tube was gradually intermittent extracted. Gastric and mediastinal drainage tubes were removed after the healing of anastomotic leakage (confirmed by oral dimeglumine fluoroscopy on POD31) (Figure 1E), and the neck incision was closed with adhesive tape immediately.
Insertion of drainage tube. Feeding tube was inserted into duodenum intraoperation via nose to afford enteral nutrition. Gastric and mediastinal drainage tubes were along primary neck incision, and both continuously decompressed. The bottom of mediastinal drainage tube was obtuse and obstructed, had 4 side holes, and 1 cm distant from the right inferior bronchus.
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F2
Chest fluoroscopy-guided mediastinal continuous decompression drainage tube (gastric drainage tube, 5.33 mm, Yangsheng Medical Science, Yangzhou, Jiangsu, China) was inserted along gastric conduit through cervical incision (Figure 2), and 100 ml brown fetid thick pus was extracted.