After returning from vacation, a 67-year-old retired judge is admitted to the emergency department with severe dyspnea. On examination, an inspiratory stridor, ecchymosis in his neck, and swelling of soft tissue and veins in his face and upper extremity veins are evident. The CT scan shows an expanding superior mediastinal hematoma. What is the most common source of mediastinal hemorrhage?
Mediastinal hemorrhage after trauma may result from blunt or penetrating injuries. Tamponade should be suspected if hypotension, cyanosis, dyspnea, and venous congestion occur.
Parotid gland surgery
Trauma
Dissecting thoracic aneurysm
Mediastinal tumor
Thorax