Posterior mediastinal hematoma – a rare case following a fall from standing height: a case report

Pasumarthy, Lakshmi

doi:10.1186/1752-1947-1-185

Cited by 9 publications

(8 citation statements)

References 6 publications

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“…Compared with younger individuals, the elderly are more prone to damage to the head, chest, lower limbs, and pelvic area after a fall . Nevertheless, it is rare for PMH to follow a simple fall, with only two such cases previously reported, both in patients taking anticoagulants . Other reported causes of PMH include injury to blood vessels, the esophagus, or the cervical vertebrae, as well as iatrogenesis and spontaneous hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

“…Falls are a frequent reason for presentation to the emergency department. Posterior mediastinal hematoma (PMH) resulting from a simple fall is potentially fatal but rare, with only two cases previously reported . We report a PMH in an individual with normal coagulation occurring after a neck hyperextension injury secondary to a fall from standing height (i.e., a simple fall).…”

Section: Introductionmentioning

confidence: 96%

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Posterior mediastinal hematoma after a simple fall in a patient with normal coagulation

Thamamongood

Onuki

Kuramochi

et al. 2015

Acute Medicine & Surgery

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Case: A 77-year-old woman presented with neck swelling and odynophagia following a fall from standing height. She had no history of antiplatelet or anticoagulant use. Computed tomography of the chest showed an isodense to hypodense soft tissue mass in the bilateral carotid space, retropharyngeal space, and posterior mediastinum. With no airway obstruction symptoms, the patient was placed on bed rest under close observation.Outcome: The mass decreased in size spontaneously over the 10 days following symptom onset, accompanied by overall clinical improvement. The patient was diagnosed with a posterior mediastinal hematoma.Conclusion: This is the first reported case of posterior mediastinal hematoma caused by a neck hyperextension injury secondary to a simple fall in a patient with normal coagulation. The outcome was good; however, emergency physicians should be aware that hematomas necessitating airway management may occur after a fall.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Posterior mediastinal hematoma after a simple fall in a patient with normal coagulation

Thamamongood

Onuki

Kuramochi

et al. 2015

Acute Medicine & Surgery

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“…The initial management is fluid resuscitation, transfusion if required, and urgent imaging. 9 Endotracheal intubation is performed for airway compromise. 2 , 9 Based on the patient’s condition and the diagnostic findings, the treatment options include the following: ( a ) operative intervention (cardiorespiratory compromise), ( b ) angiography and embolization, or ( c ) careful watch and wait (for stable patient) as in our patient.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Atraumatic Mediastinal Hemorrhage

Iskander

Siddique

Kaul

2013

Journal of Investigative Medicine High Impact Case Reports

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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.

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“…Additional presenting symptoms may include (but are not limited to) respiratory distress, hypotension, tachycardia, chest wall ecchymosis [5, 7], and dysphagia possibly secondary to compression of the esophagus by an expanding hematoma.…”

Section: Discussionmentioning

confidence: 99%

Posterior Mediastinal Hematoma after a Fall from Standing Height: A Case Report

Josse¹,

Ameer

Alzaid

et al. 2012

Case Reports in Surgery

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Posterior Mediastinal Hematomas (PMHs) secondary to a fall from standing height are uncommon, with only one previous case reported in the literature. We describe a case of a 78-year-old male with multiple medical comorbidities, who was transferred to Montreal General Hospital (MGH) with a posterior mediastinal hematoma (PMH) after sustaining a fall from standing height. On initial assessment, the patient was hemodynamically stable and complained of mild chest pain, dyspnea, fatigue, and diaphoresis. The patient's airway was secured via endotracheal intubation fearing impending respiratory compromise secondary to an enlarging PMH. The patient was admitted to ICU where over the next 3 days he was managed conservatively via careful monitoring of his hemodynamic and hematologic indices. Repeat CT scanning indicated reduction in size of the PMH. The patient was discharged on hospital day eight. This case describes the assessment, evaluation, and conservative management of PMH in a complicated patient receiving prior anticoagulation. A review of the literature regarding the epidemiology of PMH and the management of both unstable and stable PMHs is also presented.

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Posterior mediastinal hematoma – a rare case following a fall from standing height: a case report

Abstract: Introduction: We present a previously unreported complication of a fall from standing height.

Cited by 9 publications

References 6 publications

Posterior mediastinal hematoma after a simple fall in a patient with normal coagulation

Posterior mediastinal hematoma after a simple fall in a patient with normal coagulation

Spontaneous Atraumatic Mediastinal Hemorrhage

Posterior Mediastinal Hematoma after a Fall from Standing Height: A Case Report

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