Abstract
IntroductionWe present a previously unreported complication of a fall from standing height.Case presentationA 76-year-old woman sustained blunt chest trauma resulting from a fall from standing height. She was diagnosed with a mediastinal hematoma, and did well with supportive care. Follow up CT angiograms on days 2 and 4 of hospital stay revealed a stable hematoma and she did not require any intervention.ConclusionMediastinal hematoma has been reported secondary to trauma, coagulation abnormalities and hematologic malignancies, but it not been reported secondary to a fall from standing height. Factors predisposing to a hematoma in this case were aspirin therapy and a modest elevation of INR secondary to chronic hepatitis C.
Highlights
We present a previously unreported complication of a fall from standing height.Case presentation: A 76-year-old woman sustained blunt chest trauma resulting from a fall from standing height
Mediastinal hematoma has been reported secondary to trauma, coagulation abnormalities and hematologic malignancies, but it not been reported secondary to a fall from standing height
Factors predisposing to a hematoma in this case were aspirin therapy and a modest elevation of INR secondary to chronic hepatitis C
Summary
Falls from standing height are common in the elderly, but there are no other cases in the literature describing a resulting posterior mediastinal hematoma of this severity, especially without a background of bleeding diathesis. When symptoms such as sudden onset of chest pain and shortness of breath are present, especially if associated with mediastinal widening on chest X-ray, mediastinal hematoma should be considered even if the patient has fallen only from a standing height, and has not necessarily struck the chest. Her hematoma was contained and showed no sign of progression on further testing, and she was hemodynamically stable throughout her hospital course
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