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. 2013 Apr 1;1(2):2324709613484451.
doi: 10.1177/2324709613484451. eCollection 2013 Apr-Jun.

Spontaneous Atraumatic Mediastinal Hemorrhage: Challenging Management of a Life-Threatening Condition and Literature Review

Morkos Iskander  1 , Khurram Siddique  1 , Anil Kaul  1
Affiliations

Spontaneous Atraumatic Mediastinal Hemorrhage: Challenging Management of a Life-Threatening Condition and Literature Review

Morkos Iskander et al. J Investig Med High Impact Case Rep. .

Abstract

Spontaneous atraumatic mediastinal hematomas are rare. We present a case of a previously fit and well middle-aged lady who presented with acute breathlessness and an increasing neck swelling and spontaneous neck bruising. On plain chest radiograph, widening of the mediastinum was noted. The bruising was later confirmed to be secondary to mediastinal hematoma. This life-threatening diagnostic conundrum was managed conservatively with a multidisciplinary team approach involving upper gastrointestinal and thoracic surgeons, gastroenterologists, radiologists, intensivists, and hematologists along with a variety of diagnostic modalities. A review of literature is also presented to help surgeons manage such challenging and complicated cases.

Keywords: hematoma; mediastinum; spontaneous.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
A photograph demonstrating the extent of bruising at presentation.
Figure 2.
Figure 2.
CT thorax with contrast at presentation. The hematoma can be seen causing mediastinal compression.
Figure 3.
Figure 3.
MRI neck with contrast at day 7. Residual hematoma is seen in the superior mediastinum and extending into the neck along fascial layers.
See this image and copyright information in PMC

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