Mediastinal hematoma post coronary artery bypass graft

Case contributed by Dr Nolan Walker

Presentation

Day 1 post CABG. Hypoxic.

Patient Data

Age: 50 years

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Post-operative

x_ray

Mediastinal surgical clips and sternotomy wires. Left cardiomediastinal contour appears widened and is indistinct. 

Lungs and pleural spaces are clear. Cardiomediastinal contour is normal. 

CT performed 2 days after the post op CXR confirms a mediastinal hematoma.

Case Discussion

Interpretation of the mediastinum is difficult in the AP projection. Review of previous imaging can help.

In this case the new finding of an abnormal cardiac contour and new surgical clips, makes a post op hematoma very likely.

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