Posterior mediastinal hematoma after a fall from standing height: a case report

Area of Science:

• Medicine
• Cardiology
• Trauma Surgery

Background:

• Posterior mediastinal hematomas (PMHs) are rare, particularly those resulting from falls from standing height.
• Literature review indicates limited documented cases of PMHs secondary to low-energy trauma.

Observation:

• A 78-year-old male with comorbidities presented with symptoms including chest pain, dyspnea, and fatigue after a fall.
• Initial assessment revealed hemodynamic stability, but impending respiratory compromise due to an enlarging PMH necessitated endotracheal intubation.

Findings:

• The patient was managed conservatively in the ICU with close hemodynamic and hematologic monitoring.
• Serial CT scans demonstrated a reduction in the size of the posterior mediastinal hematoma.
• The patient was discharged on hospital day eight, indicating successful conservative treatment.

Implications:

• This case underscores the importance of considering conservative management for posterior mediastinal hematomas in select patients.
• Effective management involves careful patient selection, vigilant monitoring, and timely intervention when necessary.
• The findings contribute to understanding the epidemiology and management strategies for posterior mediastinal hematomas, especially in anticoagulated patients.