CASE 564 Published on 06.11.2000

Mediastinal widening consecutive to arterial hemorrhage

Section

Chest imaging

Case Type

Clinical Cases

Authors

M. Wintermark, P. Schnyder

Patient

31 years, male

Categories
No Area of Interest ; Imaging Technique CT
Clinical History
High-speed motorcycle accident
Imaging Findings
31-year-old male driver ejected from his motorcycle
Discussion
Mediastinal widening is diagnosed when the mediastinum width to chest width ratio, at the level of the aortic arch, is superior to 0.25. It is related with an aortic lesion in about 20% of cases, but may also result from other major mediastinal vessel injuries or from small vessel lesions consecutive to clavicular, sternal, rib or vertebral fractures. Finally, widened mediastunum in trauma patients may be secondary to abundant fluid perfusion with superior vena cava distension or to patient’s supine position. Spiral chest CT and/or transesophageal echography are sensitive screening imaging modalities to rule out life-threatening aortic injuries. Rarely, a thoracic aortography is needed to complete this screening survey.
Differential Diagnosis List
Compressive hemomediastinum with an unidentified arterial origin
Final Diagnosis
Compressive hemomediastinum with an unidentified arterial origin
Case information
URL: https://eurorad.org/case/564
DOI: 10.1594/EURORAD/CASE.564
ISSN: 1563-4086