Spontaneous non-traumatic mediastinal hematoma associated with oral anticoagulant therapy: A case report and literature review

Abstract

HighlightsSpontaneous mediastinal hematoma is rare but can occur in patients taking anticoagulants.Diagnosis in an early state is difficult, unless clinicians recognize and suspect this condition.Although conservative therapy is often effective, active surgical intervention is occasionally needed.We should be aware of this entity as a potential complication of anticoagulant therapy for prompt and proper management.

Spontaneous Non-Traumatic Mediastinal Hematoma in a Patient on Imatinib Therapy for a Gastrointestinal Stromal Tumor (GIST)

“…However, recent literature reports similar cases of bleeding with Imatinib use. In one study, two patients, one of them taking 600 mg (slightly above the normal dosage of Imatinib), developed liver hematomas and needed further blood transfusions and blood count monitoring [ 9 ]. Both patients developed liver hematomas within four months of Imatinib initiation [ 9 ].…”

“…In one study, two patients, one of them taking 600 mg (slightly above the normal dosage of Imatinib), developed liver hematomas and needed further blood transfusions and blood count monitoring [ 9 ]. Both patients developed liver hematomas within four months of Imatinib initiation [ 9 ]. In other studies, subdural hemorrhages have been tied to Imatinib use [ 4 ].…”

Acute Mediastinal Bleeding with Pleural Escape: Case Report of a Rare Interventional Complication with Unusual Resolve

“…Management of mediastinal bleeding includes surgical drain of mediastinal area, surgical evacuation of hematoma, or conservative approach depending on the urgency and clinical condition of the case. 7 Surgical drain is preferrable only for patient with hemodynamic instability. Surgical evacuation is usually preferred to repair the source of bleeding.…”

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“…With a documented traumatic mechanism, mediastinal hematomas usually originate after thoracic trauma or rupture of the aneurysmal aorta while the cervical ones (with normal thyroid gland) have been described after vertebral body fractures, thyroid surgery, fine needle aspiration, deceleration sudden or cervical hyperflexion. [3][4][5][6] In addition to the aforementioned causes of spontaneous hematoma, it has been described in patients with multinodular goiter, since the presence of thyroid nodules is accompanied by an increase in thyroid vascularization. Some authors such as Boris have described this entity in the immediate postpartum.…”