Abstract
A 45-year-old man with a cough and a stomachache of a few days duration was diagnosed as having bronchitis, for which he was treated, but he did not improve. Thus, computed tomography was done and showed mediastinitis and a left pulmonary abscess. At first, Boerhaave's disease was suspected, but no esophageal perforation was noted during surgery. After surgery, descending necrotizing mediastinitis was diagnosed given the patient's history and the presence of the abscess. Both Boerhaave's disease and descending necrotizing mediastinitis exhibit mediastinitis. Thus, it is difficult to differentiate these two in some cases. It is important to carefully evaluate the patient's history and to evaluate the CT of the area from the neck to the lung.
