It is usually caused by inflammation of the mediastinum with an enlarged mediastinal turbinate. Mediastinitis (mediastinitis) is divided into two types: septic and chronic fibrous lesions. Acute mediastinitis is mostly caused by bacterial infection after surgical biopsy or perforation of esophageal or tracheal tumor ulceration, and a few are caused by the spread of septic infection of the lung, pleura, and pericardium, mainly as a symptom of acute infection; chronic mediastinitis is mostly a granuloma-like lesion caused by primary tuberculosis, histoplasmosis, and nodular disease, mainly causing the manifestation of compression of the superior vena cava and other organs in the mediastinum. How to check for enlargement of the mediastinal turbinate? 1. Acute mediastinitis starts with symptoms of toxemia such as high fever and chills, often accompanied by dysphagia, retrosternal pain, and radiates to the neck or causes otalgia. If the abscess forms and compresses the trachea, it may produce high-pitched cough, dyspnea, tachycardia and cyanosis. In severe cases, shock can be life-threatening. 2. Chronic mediastinitis is usually asymptomatic in the early stage, but symptoms of adhesion or compression of mediastinal organs may gradually appear, mainly as superior vena cava obstruction syndrome, with increased venous pressure, edema of the head, face, neck and upper limbs, filling of the jugular vein, and dilated veins of the lateral circulation on the chest wall. The patient has headache, dizziness, dyspnea, and cyanosis. Due to the establishment of the collateral circulation, the obstruction can be gradually reduced and the symptoms can improve or disappear. If the lesion involves other organs, it may cause the corresponding symptoms of each organ obstruction. For example, dysphagia, cough, shortness of breath, and increased pulmonary artery pressure due to pulmonary artery compression. Occasionally, compression of the phrenic nerve may cause diaphragmatic paralysis, and compression of the recurrent laryngeal nerve may cause hoarseness. The diagnosis is mainly based on clinical manifestations, but because mediastinitis is part of the whole process of infection, and there is no special manifestation of simple mediastinitis on X-ray chest films, except for the possible widening of mediastinal shadow and mediastinal emphysema, what is seen clinically is more limited mediastinal abscess, or posterior mediastinum on lateral chest films with air-fluid surface, pneumothorax, etc., sometimes it is not easy to confirm the diagnosis. Lateral chest radiographs are important. The general bedside photography is not clear due to the projection conditions. For the convenience of diagnosis, it is best to take semi-sitting posterior-anterior chest radiographs and lateral chest radiographs. If esophageal or tracheal rupture is suspected, 40% sterile iodine oil contrast is feasible, and barium is avoided to avoid long-term retention and tissue irritation.