Widened mediastinum

Widened mediastinum
Classification and external resources
ICD-9-CM	519.3
DiseasesDB	29459

Widened mediastinum/mediastinal widening is a mediastinum with a measured width greater than 6 cm on an upright PA chest X-ray or 8 cm on supine AP chest film.

Associated conditions

A widened mediastinum can be indicative of several pathologies:^[1][2]

• aortic aneurysm^[3]
• aortic dissection^[4]
• aortic unfolding
• aortic rupture
• hilar lymphadenopathy
• anthrax inhalation - a widened mediastinum was found in 7 of the first 10 victims infected by anthrax (Bacillus anthracis) in 2001.^[5]
• esophageal rupture - presents usually with pneumomediastinum and pleural effusion. It is diagnosed with water-soluble swallowed contrast.
• mediastinal mass
• mediastinitis
• cardiac tamponade^[6]
• pericardial effusion
• thoracic vertebrae fractures in trauma patients.

References

1. Geusens; Pans, S.; Prinsloo, J.; Fourneau, I. (2005). "The widened mediastinum in trauma patients". European journal of emergency medicine : official journal of the European Society for Emergency Medicine 12 (4): 179–184. doi:10.1097/00063110-200508000-00006. PMID 16034263.
2. Richardson; Wilson, M. E.; Miller, F. B. (1990). "The widened mediastinum. Diagnostic and therapeutic priorities". Annals of Surgery 211 (6): 731–736; discussion 736–7. doi:10.1097/00000658-199006000-00012. PMC 1358125. PMID 2357135.
3. Chandra S, Laor YG (April 1975). "Lung scan and wide mediastinum". J. Nucl. Med. 16 (4): 324–5. PMID 1113190.
4. von Kodolitsch Y, Nienaber C, Dieckmann C, Schwartz A, Hofmann T, Brekenfeld C, Nicolas V, Berger J, Meinertz T (2004). "Chest radiography for the diagnosis of acute aortic syndrome". Am J Med 116 (2): 73–7. doi:10.1016/j.amjmed.2003.08.030. PMID 14715319.
5. Jernigan JA, Stephens DS, Ashford DA, et al. (2001). "Bioterrorism-related inhalational anthrax: the first 10 cases reported in the United States". Emerging Infect. Dis. 7 (6): 933–44. doi:10.3201/eid0706.010604. PMC 2631903. PMID 11747719.
6. Gideon P. Naudé; Fred S. Bongard; Demetrios Demetriades (2003). Trauma secrets. Elsevier Health Sciences. pp. 95–. ISBN 978-1-56053-506-5. Retrieved 19 April 2010.