[Spontaneous hematoma of the mediastinum]

We report a case of spontaneous mediastinal haematoma. This unusual clinical entity, though uncommon, must be considered in any patient presenting with the typical triad of symptoms of acute superior mediastinal compression, widening of the superior mediastinum on chest radiographs, bruises on the neck appearing within 48 hours of exertion, sneezing, coughing or vomiting. The signs observed with computed tomography in mediastinal haemorrhage are described. The exact source of the haemorrhage remains unknown despite careful radiological investigation and thoracotomy.