title: Mediastinal hematoma: another lethal sign of aortic dissection.
abstract: Acute compressive hemomediastinum due to type A acute aortic dissection in a 70-year-old man caused acute simultaneous obstruction of pulmonary artery and superior vena cava, leading to sudden death, presenting acute progressive bruising of the upper half of the body and subsequent massive hemoptysis. Computed tomography scanning revealed acute severe stenosis of the superior vena cava and right pulmonary artery by mediastinal hematoma. Mediastinal hematoma combined with simultaneous obstruction of pulmonary artery and superior vena cava is a rare entity and should be recognized as one of the acutely fatal signs of type A dissection.
authors.affiliation: Department of Cardiovascular Surgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan. yosito_inoue@saimiya.com
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Inoue
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Takahashi
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kashima
authors.forename: Koji
authors.initials: K
authors.lastname: Tsutsumi
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D001014:Aortic Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D003251:Constriction, Pathologic; D003288:Contusions / Q000209:etiology; D017809:Fatal Outcome; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology*; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000209:etiology; D014057:Tomography, X-Ray Computed