Bolesta M J, Bohlman H H
Department of Orthopaedics, Case Western Reserve University, Cleveland, Ohio.
J Bone Joint Surg Am. 1991 Mar;73(3):447-50.
Widening of the mediastinum, when seen on radiographs of the chest in victims of trauma, is usually attributed to injury to the aorta. An aortic injury, when not lethal, often causes paraparesis or paraplegia due to ischemia of the spinal cord. A fracture of the upper thoracic spine can produce similar clinical and radiographic findings. The cases of three patients who had those findings are presented; in all three, the differential diagnosis between the vascular and skeletal injuries was difficult. Fracture of the thoracic spine should be included in the differential diagnosis whenever mediastinal widening is seen on radiographs.
在创伤患者的胸部X光片上看到纵隔增宽时，通常归因于主动脉损伤。主动脉损伤若未致命，常因脊髓缺血导致双下肢轻瘫或截瘫。上胸椎骨折可产生类似的临床和影像学表现。本文报告了三名有这些表现的患者病例；在所有三例中，血管损伤和骨骼损伤的鉴别诊断都很困难。每当X光片上出现纵隔增宽时，胸椎骨折都应列入鉴别诊断范围。
