Abstract
This review article provides information on the causes of primary mediastinitis. Back in the 19th century, surgeons identified two ways for infection to penetrate the mediastinum: from the esophagus when it is perforated and from the cellular spaces of the neck. This corresponds to the division of mediastinitis into primary and secondary. Purulent mediastinitis is considered primary if it develops as a primary purulent complication of diseases and injuries of the mediastinal organs. Secondary purulent mediastinitis develops with contact or metastatic spread of the purulent process to the mediastinum, in the presence of a primary purulent focus outside the mediastinal tissue. From a clinical point of view, it seems appropriate to single out postoperative mediastinitis in a special group. It is concluded that the relevance of primary mediastinitis remains and knowledge in this field of surgery is still in demand.