INTRODUCTION
For A PATIENT to survive a perforation of the esophagus and a subsequent suppurative mediastinitis in the prechemotherapy and preantibiotic era was a nearmiraculous happening. This is the tragic report of a girl who did just that, only to develop a recurrence of the mediastinal infection 18 years later. This time, in spite of all the modern antibiotic agents and surgical techniques, she never recovered from the complication.The case is presented in elaborate detail because of its many challenging facts, which at one time or another involved nearly every surgical specialty as well as internal medicine and psychiatry. Furthermore, the patient's sudden demise and the unexplainable gross anatomic findings at autopsy made this a most thought-provoking clinical problem.
REPORT OF A CASE
A 19-year-old white female college student had been in good health until one week prior to Oct. 3, 1952. At that time she was seen