CASE 548 Published on 22.07.2001

Blunt traumatic sternal fracture and tear of the left internal mammary artery

Section

Chest imaging

Case Type

Clinical Cases

Authors

M. Wintermark, P. Schnyder

Patient

47 years, female

Categories
No Area of Interest ; Imaging Technique CT
Clinical History
Fall from a height
Imaging Findings
47-year-old female patient who tried to commit suicide and fell from a 20-m bridge
Discussion
In 16% of cases, sternal fractures are associated with lesions of the internal mammary vessels or their branches and thus result in retrosternal hematomas. But, even in such cases, as long as sternal fractures are isolated, they rarely induce enough bleeding to widen the mediastinum on chest X-ray. Thus, mediastinal widening in presence of a sternal fracture necessitate to rule out an aortic or great vessel lesion. This is performed by chest CT, which is the diagnostic survey modality of choice for chest trauma patients. Moreover, chest CT advantageously demonstrates most sternal fracture lines, even when transverse, sternal displacements, retrosternal hematomas and internal thoracic vessel injuries. Chest CT has completely replaced lateral chest radiograph, which is no longer obtained in blunt chest trauma patients
Differential Diagnosis List
Blunt traumatic sternal fracture with lesion of the left internal mammary artery and subsequent hemomediastinum
Final Diagnosis
Blunt traumatic sternal fracture with lesion of the left internal mammary artery and subsequent hemomediastinum
Case information
URL: https://eurorad.org/case/548
DOI: 10.1594/EURORAD/CASE.548
ISSN: 1563-4086