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

Iskander M, Siddique K, Kaul A - J Investig Med High Impact Case Rep (2013)

Bottom Line: 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.A review of literature is also presented to help surgeons manage such challenging and complicated cases.

View Article: PubMed Central - PubMed

Affiliation: St Helen's & Knowsley NHS Trust, Whiston Hospital, Liverpool, UK.

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.

No MeSH data available.


Related in: MedlinePlus

A photograph demonstrating the extent of bruising at presentation.
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fig1-2324709613484451: A photograph demonstrating the extent of bruising at presentation.

Mentions: A 59-year-old woman presented to the emergency department with a 1-day history of acute chest tightness with exertional dyspnea, an increasing neck swelling, and spontaneous neck bruising (Figure 1). The neck swelling has increased gradually over 2 days, leading to intermittent dysphagia. She denied any history of trauma, vomiting, regurgitation of food, bouts of cough, palpitations, or any other constitutional symptoms. Her past history included a history of paroxysmal atrial fibrillation and gastroesophageal reflux disease. There was no history of bleeding disorders. At presentation she was pale and sweaty. Her vitals were pulse 87 beats/min, blood pressure of 143/57 mm Hg, respiratory rate 16, and oxygen saturation 96% on room air.


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

Iskander M, Siddique K, Kaul A - J Investig Med High Impact Case Rep (2013)

A photograph demonstrating the extent of bruising at presentation.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4528791&req=5

fig1-2324709613484451: A photograph demonstrating the extent of bruising at presentation.
Mentions: A 59-year-old woman presented to the emergency department with a 1-day history of acute chest tightness with exertional dyspnea, an increasing neck swelling, and spontaneous neck bruising (Figure 1). The neck swelling has increased gradually over 2 days, leading to intermittent dysphagia. She denied any history of trauma, vomiting, regurgitation of food, bouts of cough, palpitations, or any other constitutional symptoms. Her past history included a history of paroxysmal atrial fibrillation and gastroesophageal reflux disease. There was no history of bleeding disorders. At presentation she was pale and sweaty. Her vitals were pulse 87 beats/min, blood pressure of 143/57 mm Hg, respiratory rate 16, and oxygen saturation 96% on room air.

Bottom Line: 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.A review of literature is also presented to help surgeons manage such challenging and complicated cases.

View Article: PubMed Central - PubMed

Affiliation: St Helen's & Knowsley NHS Trust, Whiston Hospital, Liverpool, UK.

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.

No MeSH data available.


Related in: MedlinePlus