The widened mediastinum

CHAPTER 8 The widened mediastinum



The widened mediastinum 140


image image

This is the film of a patient with a descending thoracic aortic aneurysm. The mediastinum is widened to the left of the midline throughout its length, with increased convexity around the aortic arch.


Always look carefully at the mediastinum. If you think that it is widened then relate this finding to the clinical history. Try to find some old films and see if the mediastinum has got larger. Be aware that a normal chest X-ray does not exclude a significant aortic event, such as a dissection, and in the presence of clinical suspicion an urgent CT may be an appropriate investigation.


Important causes of a widened mediastinum are thyroid enlargement, enlargement of mediastinal lymph nodes, aortic dilatation, dilatation of the oesophagus or thymic tumours. In deciding a likely cause, go through the following process:


1. Check the rotation of the film. A badly rotated film can make the mediastinum appear widened.

Related posts:

The abnormal hilum Abnormal ribs Localizing lesions The hidden abnormality The CT scan The black lung field

Stay updated, free articles. Join our Telegram channel
Tags:
Sep 3, 2016 | Posted by in RESPIRATORY IMAGING | Comments Off on The widened mediastinum

Full access? Get Clinical Tree
Get Clinical Tree app for offline access