What causes mediastinal hematoma?
Mediastinal hematoma is an uncommon finding in blunt chest trauma. It may be caused by aortic injury, by mediastinal vascular injury such as aortic injury, and by fractures of the sternum and vertebral column.
What is mediastinal hematoma?
A mediastinal hematoma is defined as presence of blood within the mediastinum as it dissects fascial planes. Traumatic etiologies that can contribute to a widened mediastinum, either in isolation or associated with an aortic injury, include vertebral or sternal fractures or a ruptured esophagus.
How is intrathoracic bleeding treated?
Thoracotomy is the procedure of choice for patients with haemodynamic instability due to active bleeding. Surgical exploration allows control of the source of bleeding and evacuation of the intrathoracic blood.
What happens if hemothorax is not treated?
Infection: a hemothorax that goes untreated may also cause an infection in the lung, pleura, or pleural fluid in the chest cavity. Scarring: the pleural membranes and lung tissue are also more prone to scarring with hemothorax. Over time, this can lead to fibrosis and immobilized ribs.
How do you treat hemothorax?
The goal of treatment is to get the person stable, stop the bleeding, and remove the blood and air in the pleural space.
- A chest tube is inserted through the chest wall between the ribs to drain the blood and air.
- It is left in place and attached to suction for several days to re-expand the lung.
How are mediastinal tumors treated?
Treatment for mediastinal tumors depends on the type of tumor and symptoms: Thymic cancers are treated with surgery. It may be followed by radiation or chemotherapy, depending on the stage of the tumor and the success of the surgery. Germ cell tumors are usually treated with chemotherapy.
What medications are used for hemothorax?
Some centers prefer the use of tissue plasminogen activator (TPA). In a study of intrapleural fibrinolytic treatment of traumatic clotted hemothorax, daily instillations of fibrinolytic agents into the intrapleural the space for 2-15 days resulted in an overall success rate of 92%.