[Spontaneous mediastinal hematoma during therapy with oral anticoagulants]

Mediastinal haematoma as a complication of anticoagulant therapy has rarely been described in the literature. A case is reported of an anterior mediastinal haematoma which developed in a patient with mitral valve disease while on oral anticoagulant therapy. This occurred in spite of well-controlled anticoagulation therapy and the clinico-radiological features did not directly recall the hemorrhagic complication. Computerized tomographic scan of the chest, even if not conclusive, was essential for the clinical strategy. A definite diagnosis was obtained by percutaneous needle aspiration followed by iodinate contrast medium injection. This procedure also led to the resolution of the haematoma, thus avoiding hazardous surgical therapy.