Mediastinal hematoma

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See also Thoracic aortic injury

Overview
Mediastinal hematomas are usually caused by;


 * 1) Thoracic trauma,
 * 2) *Blunt trauma (more common)
 * Rapid deceleration (e.g. motor vehicle accident, fall from great height)
 * Crush injury
 * 1) *Penetrating trauma
 * Stab wound
 * Gun shot wound
 * 1) Cardiac and great vessel aneurysm or rupture
 * 2) Iatrogenic factors associated with invasive procedures and surgery
 * 3) Coagulation abnormalities (bleeding diathesis)
 * 4) Neoplasms
 * 5) Spontaneous
 * 6) Sneezing
 * 7) Coughing
 * 8) Emesis
 * 9) Uremia,
 * 10) Renovascular hypertension

Diagnosis
The gold standard diagnostic modalities are angiography and surgical exploration.

Management
Asymptomatic mediastinal hematomas can be diagnosed by using noninvasive modalities and may be appropriately treated conservatively, with a period of observation for hematoma progression or regression. For uncommon, suspicious, or symptomatic mediastinal hematomas, surgical intervention using median sternotomy for adequate surgical exposure, greater cardiovascular control, and hemostasis is prompt management.