Rapid onset mediastinal hematoma due to vertebral fracture and review of relevant literature

Vaner Koksal; Selcuk Coskun; Pinar Koksal Coskun

doi:10.1016/j.tjem.2014.09.004

Vaner Koksal¹, Selcuk Coskun², Pinar Koksal Coskun³

¹Department of Neurosurgery, Rize Training and Research Hospital, Recep Tayyip Erdogan University, Rize, Turkey
²Department of Emergency, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
³Department of Cardiovascular Surgery, Ankara Tobb-etu Hospital, Ankara, Turkey

Keywords: Mediastinal hematoma; Mediastinal hemorrhage; Thoracic vertebral fracture; Vertebra fracture

Abstract

Patients with vertebral fractures are frequently encountered and those with thoracic and lumbar spine fractures are likely to have associated injuries. Detection of a widened mediastinum after trauma is very nonspecific and most of the time it is related to aortic injury or mediastinal hematoma. Vertebral or sternal fractures can also be the cause of mediastinal hematoma with or without aortic injury.

This report reviews an unusual case of rapid onset mediastinal hematoma due to vertebral fracture after a fall.

In the case, there was a mediastinal hematoma adjacent to a burst fracture of the T8 vertebral body. There was a rapid increase in identified hematoma during the emergency follow up and urgent erythrocyte transfusion was carried out.

We would like to raise awareness of this infrequent presentation of mediastinal hematoma, as it is insidious and possibly fatal. In the evaluation of mediastinal hematoma, the detection of osseous injuries is a requirement.