Iskander Morkos, Siddique Khurram, Kaul Anil
St Helen's & Knowsley NHS Trust, Whiston Hospital, Liverpool, UK.
J Investig Med High Impact Case Rep. 2013 Apr 1;1(2):2324709613484451. doi: 10.1177/2324709613484451. eCollection 2013 Apr-Jun.
Spontaneous atraumatic mediastinal hematomas are rare. We present a case of a previously fit and well middle-aged lady who presented with acute breathlessness and an increasing neck swelling and spontaneous neck bruising. On plain chest radiograph, widening of the mediastinum was noted. The bruising was later confirmed to be secondary to mediastinal hematoma. This life-threatening diagnostic conundrum was managed conservatively with a multidisciplinary team approach involving upper gastrointestinal and thoracic surgeons, gastroenterologists, radiologists, intensivists, and hematologists along with a variety of diagnostic modalities. A review of literature is also presented to help surgeons manage such challenging and complicated cases.
自发性非创伤性纵隔血肿较为罕见。我们报告一例病例，患者为一名既往健康的中年女性，出现急性呼吸困难、颈部肿胀加重及自发性颈部瘀斑。胸部X线平片显示纵隔增宽。后来证实瘀斑是由纵隔血肿引起的。通过多学科团队方法进行保守治疗，该方法涉及上消化道和胸外科医生、胃肠病学家、放射科医生、重症监护医生和血液科医生，同时采用了多种诊断方式。本文还对文献进行了综述，以帮助外科医生处理此类具有挑战性和复杂性的病例。
