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Case Reports in Surgery
Volume 2012, Article ID 672370, 4 pages
http://dx.doi.org/10.1155/2012/672370
Case Report

Posterior Mediastinal Hematoma after a Fall from Standing Height: A Case Report

1Ross University School of Medicine, 630 US Highway 1, North Brunswick, NJ 08902, USA
2McGill University Medical Center, The Montreal General Hospital, 1650 Cedar Avenue, Montreal, QC, Canada H3G 1A4
3Trauma Program, Trauma Surgery and Critical Care Medicine, McGill University Health Centre, 1650 Cedar Avenue, L9.411, Montreal, QC, Canada H3G 1A4

Received 25 October 2011; Accepted 6 December 2011

Academic Editors: A. Anselmi, C. Foroulis, and J. Jougon

Copyright © 2012 J. M. Josse et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Posterior Mediastinal Hematomas (PMHs) secondary to a fall from standing height are uncommon, with only one previous case reported in the literature. We describe a case of a 78-year-old male with multiple medical comorbidities, who was transferred to Montreal General Hospital (MGH) with a posterior mediastinal hematoma (PMH) after sustaining a fall from standing height. On initial assessment, the patient was hemodynamically stable and complained of mild chest pain, dyspnea, fatigue, and diaphoresis. The patient's airway was secured via endotracheal intubation fearing impending respiratory compromise secondary to an enlarging PMH. The patient was admitted to ICU where over the next 3 days he was managed conservatively via careful monitoring of his hemodynamic and hematologic indices. Repeat CT scanning indicated reduction in size of the PMH. The patient was discharged on hospital day eight. This case describes the assessment, evaluation, and conservative management of PMH in a complicated patient receiving prior anticoagulation. A review of the literature regarding the epidemiology of PMH and the management of both unstable and stable PMHs is also presented.