-
Journal of the Royal College of... Aug 1991
Topics: Aged; Aged, 80 and over; Female; Hematoma; Humans; Mediastinal Diseases; Radiography
PubMed: 1941752
DOI: No ID Found -
The National Medical Journal of India 2017
Topics: Catheterization, Central Venous; Hematoma; Humans; Male; Mediastinal Diseases; Mediastinum; Middle Aged; Tomography, X-Ray Computed
PubMed: 30117456
DOI: 10.4103/0970-258X.239090 -
Medicina (Kaunas, Lithuania) Nov 2022: Cervical space infection could also extend to the mediastinum due to the anatomical vicinity. The mortality rate of descending necrotizing mediastinitis is 85% if...
: Cervical space infection could also extend to the mediastinum due to the anatomical vicinity. The mortality rate of descending necrotizing mediastinitis is 85% if untreated. The aim of this study was to identify risk factors for the progression of deep neck abscesses to descending necrotizing mediastinitis. : We retrospectively reviewed the medical records of patients undergoing surgical treatment of deep neck abscesses from August 2017 to July 2022. Computed tomography (CT) was performed in all patients. Before surgery, lab data including hemoglobulin (Hb), white blood cell count, neutrophil percentage, C-reactive protein (CRP) level, and blood glucose were recorded. Patients' characteristics including gender, age, etiology, and presenting symptoms were collected. Hospitalization duration and bacterial cultures from the wound were also analyzed. : The C-reactive protein (CRP) level was higher in patients with a mediastinal abscess than in patients without a mediastinal abscess (340.9 ± 33.0 mg/L vs. 190.1 ± 72.7 mg/L) ( = 0.000). The submandibular space was more commonly affected in patients without a mediastinal abscess ( = 0.048). The retropharyngeal ( = 0.003) and anterior visceral ( = 0.006) spaces were more commonly affected in patients with a mediastinal abscess. : Descending necrtotizing mediastinitis results in mortality and longer hospitalization times. Early detection of a mediastinal abscess on CT is crucial for treatment. Excluding abscesses of the anterior superior mediastinum for which transcervical drainage is sufficient, other mediastinal abscesses require multimodal treatment including ENT and thoracic surgery to achieve a good outcome.
Topics: Humans; Abscess; Mediastinitis; Retrospective Studies; C-Reactive Protein; Neck; Risk Factors; Necrosis
PubMed: 36556959
DOI: 10.3390/medicina58121758 -
Kyobu Geka. the Japanese Journal of... Dec 2005We report a rare case of mediastinal hemorrhage after pulmonary resection. A 64-year-old woman with hypersensitivity pneumonitis was diagnosed as adenocarcinoma of the...
We report a rare case of mediastinal hemorrhage after pulmonary resection. A 64-year-old woman with hypersensitivity pneumonitis was diagnosed as adenocarcinoma of the lung by bronchoscopical examination. Left lower lobectomy and mediastinal lymph node dissection were performed. Sudden chest pain and dry cough developed 14 days after the operation. Her diastolic pressure rose transiently but electrocardiogram remained normal. Chest X-ray showed widening of the mediastinum and enhanced chest computed tomography (CT) showed extravasation of the contrast media just under the bifurcation of the trachea. Multi projection volume reconstruction revealed mediastinal hemorrhage from the bronchial artery. The chest pain disappeared after a successful bronchial artery embolization and the patient discharged 21 days later. Hemorrhage after pulmonary resection is a common complication, but no previous report has described mediastinal hemorrhage occurring 2 weeks after the operation. In a similar case, bronchial artery embolization is a reliable and minimally invasive therapy for mediastinal hemorrhage.
Topics: Adenocarcinoma; Bronchial Arteries; Embolization, Therapeutic; Female; Humans; Lung Neoplasms; Mediastinum; Middle Aged; Pneumonectomy; Postoperative Hemorrhage
PubMed: 16359020
DOI: No ID Found -
The American Journal of Case Reports Jan 2021BACKGROUND Fibrosing mediastinitis is a rarely seen, progressive disease. It results from an excessive fibrotic reaction in the mediastinum. We describe a presentation...
BACKGROUND Fibrosing mediastinitis is a rarely seen, progressive disease. It results from an excessive fibrotic reaction in the mediastinum. We describe a presentation of fibrosing mediastinitis that, to our knowledge, has never been seen before. CASE REPORT A 30-year-old female Colombian flight attendant presented with a right eyelid droop. Examination revealed partial right-sided ptosis and miosis but no anhidrosis. An ill-defined firm swelling was palpable at the root of the neck. Chest radiography revealed a widened mediastinum, and computerized tomography (CT) showed a right paratracheal mass without calcification extending to the thoracic inlet, encasing multiple blood vessels. All basic blood tests, magnetic resonance imaging of the head, and ultrasound Doppler of the neck vessels were normal. History and work up for infections including fungal diseases, granulomatous diseases, vasculitis, and autoimmune diseases were negative. Positron emission tomography (PET) showed significant FDG uptake in the mediastinum. Mediastinal biopsy was histologically consistent with fibrosing mediastinitis. All relevant immunohistochemistry and microbiological studies were negative. Subsequently, the patient developed signs of superior vena cava compression; this was managed by balloon angioplasty, which resulted in improvement of symptoms. However, over time, her symptoms worsened progressively, resulting in a left-sided ptosis and radiological progression of the mass on CT. She received treatment with rituximab and concomitant steroids, which yielded excellent results: the treatment led to both resolution of her symptoms and regression of the mass and its metabolic activity on PET scan. CONCLUSIONS Fibrosing mediastinitis can present with an incomplete Horner's syndrome. Treatment with rituximab and steroids shows promising results in select cases of metabolically active idiopathic fibrosing mediastinitis.
Topics: Adult; Blepharoptosis; Female; Humans; Mediastinitis; Miosis; Sclerosis
PubMed: 33431787
DOI: 10.12659/AJCR.927556 -
Internal Medicine (Tokyo, Japan) 2014
Topics: Acute Disease; Esophageal Perforation; Hematoma; Humans; Male; Mediastinitis; Middle Aged; Radiography; Remission, Spontaneous; Vomiting
PubMed: 25130131
DOI: 10.2169/internalmedicine.53.2795 -
The American Journal of Case Reports Dec 2015We report a case of surgical central venous port system implantation using Seldinger's technique with a life-threatening mediastinal hematoma due to the perforation of...
BACKGROUND
We report a case of surgical central venous port system implantation using Seldinger's technique with a life-threatening mediastinal hematoma due to the perforation of the superior vena cava.
CASE REPORT
A 68-year-old woman was admitted to our institution for port implantation. Open access to the cephalic vein and 2 punctures of the right subclavian vein were unsuccessful. Finally, the port catheter could be placed into the superior vena cava using Seldinger's technique. As blood aspiration via the port catheter was not possible, fluoroscopy was performed, revealing mediastinal contrast extravasation without contrasting the venous system. A new port system could be placed in the correct position without difficulties. After extubation, the patient presented with severe respiratory distress and required consecutive cardiopulmonary resuscitation and reintubation. The CT scan showed a significant hematoma in the lower neck and posterior mediastinum with tracheal compression. We assumed a perforation of the superior vena cava with the tip of the guidewire using Seldinger's technique. Long-term intensive treatment with prolonged ventilation and tracheotomy was necessary. The port system had to be subsequently explanted due to infection.
CONCLUSIONS
Mediastinal hematoma is a rare but life-threatening complication associated with central venous catheterization using Seldinger's technique. Perforation occurs most often during central venous catheterization in critical care. Mediastinal hematoma is an example of a mechanical complication occurring after central venous catheterization, which has been described only a few times in the literature to date. This case highlights the importance of awareness of possible, rare, life-threatening complications during port implantation, mostly performed in multimorbid patients by surgeons in training.
Topics: Aged; Angiography; Catheterization, Central Venous; Central Venous Catheters; Female; Fluoroscopy; Hematoma; Humans; Mediastinum; Phlebography; Subclavian Vein; Tomography, X-Ray Computed
PubMed: 26703924
DOI: 10.12659/ajcr.895486 -
International Journal of Cardiology May 1991A patient with Ehlers-Danlos syndrome presented acutely with clinical and radiological features suggestive of aortic dissection. Further investigations including...
A patient with Ehlers-Danlos syndrome presented acutely with clinical and radiological features suggestive of aortic dissection. Further investigations including computerised tomography and aortography showed mediastinal haematoma with no evidence of aortic dissection. He was treated conservatively with no complications. The typical clinical and radiological features are reviewed and an emphasis is made on accurate diagnosis to allow prompt, appropriate management.
Topics: Adult; Aortic Dissection; Aortic Aneurysm; Diagnosis, Differential; Ehlers-Danlos Syndrome; Hematoma; Humans; Male; Mediastinal Diseases; Radiography
PubMed: 1869336
DOI: 10.1016/0167-5273(91)90224-d -
Revue Des Maladies Respiratoires Mar 2019Endobronchial ultrasound-guided trans-bronchial needle aspiration (EBUS-TBNA) has emerged as a minimally invasive, highly accurate technique for sampling intrathoracic...
INTRODUCTION
Endobronchial ultrasound-guided trans-bronchial needle aspiration (EBUS-TBNA) has emerged as a minimally invasive, highly accurate technique for sampling intrathoracic lymph nodes. The complication rate after EBUS-TBNA is estimated at between 0.22% to 1.44%. Analysis of the different series of EBUS-TBNA reveals that mediastinal haematoma has not been described as a complication.
CASE REPORT
We describe the case of a 65-year-old-man who underwent an EBUS-TBNA of a subcarinal lymph node. Few days later the patient presented with haemoptysis of average amount associated with a haematoma in the subcarinal area seen on CT-scan. It was suggested that puncture of a bronchial artery occurred during passage of the needle. This complication occurred during the change from treatment by low molecular weight heparin to antivitamine K. The patient was monitored in the intensive care unit and received medical treatment only.
CONCLUSIONS
This patient developed a complication after an EBUS-TBNA that is rarely described and probably under diagnosed. This complication occurred during the change between two anticoagulant treatments, which requires special attention in this particular context.
Topics: Aged; Bronchoscopy; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Hematoma; Humans; Lymph Nodes; Male; Mediastinal Diseases; Postoperative Complications
PubMed: 30704807
DOI: 10.1016/j.rmr.2018.08.024 -
Archivos de Bronconeumologia Jan 2024
Topics: Humans; Thoracic Surgery, Video-Assisted; Mediastinum; Mediastinal Neoplasms; Hematoma; Hemorrhage; Iatrogenic Disease
PubMed: 37867128
DOI: 10.1016/j.arbres.2023.10.001