Incidence and significance of traumatic mediastinal haematoma.

Sandor, Francis

doi:10.1136/thx.22.1.43

Cited by 44 publications

(10 citation statements)

References 20 publications

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“…Frequently supine chest films of blunt trauma patients present a widened mediastinum induced by the patient position or due to normal mediastinal fat or to overdistention of the superior vena cava by a large amount of fluid perfusion. According to Sandor [11], hemomediastinum arises from small venous tears, vertebral or rib fractures in 87.5 % of cases. Indirect signs of aortic trauma with hemomediastinum and peri-aortic hematoma, such as a right displaced trachea, a depressed left bronchus, a blurring of the aortic knob, or fracture of the first ribs on the chest plain film have poor predictive value [2,3,10].…”

Section: Discussionmentioning

confidence: 99%

Spiral CT aortography: an efficient technique for the diagnosis of traumatic aortic injury

et al. 1998

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The objective of this study was to assess the efficiency of spiral CT (SCT) aortography for diagnosing acute aortic lesions in blunt thoracic trauma patients. Between October 1992 and June 1997, 487 SCT scans of the chest were performed on blunt thoracic trauma patients. To assess aortic injury, the following SCT criteria were considered: hemomediastinum, peri-aortic hematoma, irregular aspect of the aortic wall, aortic pseudodiverticulum, intimal flap and traumatic dissection. Aortic injury was diagnosed on 14 SCT examinations (2.9 %), five of the patients having had an additional digital aortography that confirmed the aortic trauma. Twelve subjects underwent surgical repair of the thoracic aorta, which in all but one case confirmed the aortic injury. Two patients died before surgery from severe brain lesions. The aortic blunt lesions were confirmed at autopsy. According to the follow-up of the other 473 patients, we are aware of no false-negative SCT examination. Our limited series shows a sensitivity of 100 % and specificity of 99.8 % of SCT aortography in the diagnosis of aortic injury. It is concluded that SCT aortagraphy is an accurate diagnostic method for the assessment of aortic injury in blunt thoracic trauma patients.

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Section: Discussionmentioning

confidence: 99%

Spiral CT aortography: an efficient technique for the diagnosis of traumatic aortic injury

et al. 1998

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“…Traumatic injury of the LIMA is uncommon, particularly as a result of blunt trauma, but is a possible cause of mediastinal widening and bleeding from vessels other than the aorta and its major branches, including the intercostal arteries (11). Among 16 cases of mediastinal trauma, 5 were found to have mediastinal widening caused by haemorrhage from chest-wall vessels (11).…”

Section: Discussionmentioning

confidence: 99%

Thoracic Vascular Injuries: A Major Problem in Trauma

Rashid

Wikström²,

Örtenwall³

2001

Scandinavian Cardiovascular Journal

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“…Radiological examination usually reveals broadening of the mediastinal shadow and a fracture of a lower cervical or upper thoracic vertebra. The position of the trachea is important (Sandor, 1967). If the trachea is deviated to the right the haemomediastinum is likely to be the iresult of an aortic injury and aortography is indicated.…”

Section: Case Reportmentioning

confidence: 99%

Haemomediastinum in a haemophiliac after minor trauma

Jivani

Mann

1970

Thorax

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Haemomediastinum is a very rare complication in haemophilia. Its occurrence after a minor chest injury in a boy aged 11 years is described. Complete recovery followed conservative treatment, which consisted of the correction of the coagulation defect with cryoprecipitate-AHG for 11 days, and a blood transfusion.Severe haemophilia is characterized by episodes of bleeding which may be spontaneous or traumatic in origin. This commonly results in haemarthroses and muscle haematomata, but occasionally serious internal bleeding (for example, retroperitoneal or subdural) occurs.We have recently encountered the very rare complication of haemomediastinum in a known haemophiliac. The occurrence of haemothorax has been reported (Barrett and Israels, 1965) and two examples of hae-mopericardium have been described (Anderson, 1964;Gaston, Mach, and Beck, 1961). However, haemomediastinum has been recorded previously only in association with bleeding in the neck, from which blood tracked into the mediastinum (Edmonds, 1951 ;Pochedly and Rosales, 1968). The purpose of this report is to describe the occurrence and treatment of haemomediastinum arising in a haemophiliac boy after a minor chest injury. CASE REPORTAn 11-year-old boy was found to be a haemophiliac at the age of 15 months when excessive bruising after slight trauma was investigated. He has no detectable Factor VIII activity in the plasma and has suffered numerous bleeding episodes, including haemarthroses, haematuria and a retroperitoneal haematoma. On (Fig. 1). Initial treatment consisted of cryoprecipitate-AHG, 9 units intravenously (1 unit=yield of Factor VIII concentrate from 1 pint (0-57 litre) of blood), together with 3 pints (1'7 litres) of blood. Thereafter 12-hourly intravenous injections of cryoprecipitate-AHG were given for 7 days in doses adequate to maintain the plasma Factor VIII level above 10% ; 6-8 units 12-hourly was required. Daily doses were continued for a further 4 days. We tested for the presence of inhibitors of Factor VIII in our patient's plasma and none was found.Progress was satisfactory, with relief of the chest pain within 36 hours. The cervical swelling dis-372 on 11 May 2018 by guest. Protected by copyright.

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Incidence and significance of traumatic mediastinal haematoma.

Cited by 44 publications

References 20 publications

Spiral CT aortography: an efficient technique for the diagnosis of traumatic aortic injury

Spiral CT aortography: an efficient technique for the diagnosis of traumatic aortic injury

Thoracic Vascular Injuries: A Major Problem in Trauma

Haemomediastinum in a haemophiliac after minor trauma

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