Widened mediastinum

Introduction Mediastinal widening: mediastinal inflammation, hematoma, abscess, paratracheal lymph node, mediastinal tumor and cyst, superior vena cava and azygotic vein dilatation, aneurysm, mediastinal pleural effusion, etc. can widen the mediastinum, combined with clinical and Medical history, if necessary, tomography, angiography and other inspection methods to determine the reasons for the widening. The mediastinum is a general term for organs, structures, and connective tissues between the left and right mediastinal pleura. The mediastinum is sagittal, located in the middle of the chest, to the left, narrow and wide, long and short. The anterior boundary of the mediastinum is the sternum, the posterior border is the spine, the mediastinal pleura on both sides, the upper boundary is the upper thoracic, and the lower boundary is the iliac crest. Under normal circumstances, the mediastinal position is relatively fixed. When a pneumothorax occurs on one side, the mediastinum shifts to the opposite side.

Cause

There are many tissues and organs in the mediastinum, and the source of fetal growth structure is complex, so there are many kinds of tumors in the mediastinum. There are original, there are transfers. Benignity is more common in primary tumors, but a considerable part is malignant.

an examination

Related inspection

CT examination of tumor associated antigen

1. Have dry cough, chest pain, shortness of breath or hoarseness, diaphragmatic paralysis and superior vena cava compression syndrome.

2. Chest radiograph or CT examination found the source of the mediastinum.

3. Thyroid scan for posterior sternal goiter.

4. Mediastinoscopy can help with diagnosis.

Differential diagnosis

Different from mediastinal emphysema, the mediastinal pleural connective tissue is filled with gas as mediastinal emphysema, which is a sign rather than a single disease. Due to the rupture of the alveoli, the gas gradually invades the mediastinum from the perivascular space of the pulmonary interstitial; it can also be caused by the rupture of the pleural and mediastinal pleura of the lung, the pneumothorax, trachea, bronchus or esophagus perforation caused by gas entering the pleura. The gap enters the mediastinum. The mediastinal gas can continue to rise along the anterior fascial space of the spine, the trachea, and the perivascular space to the neck, forming subcutaneous emphysema in the neck; or pneumothorax caused by gas rupture through the mediastinal pleura into the pleural cavity. In addition, gastrointestinal rupture, gas up through the mesentery, posterior peritoneal space up to the mediastinum; can also be caused by subcutaneous emphysema in the neck to the mediastinum; use of artificial respirator pressure, artificial gastro-abdominal surgery after peritoneal injection Forms mediastinal emphysema.

In trauma, such as esophagus, tracheal stab wounds, chest closure injury, trachea, bronchial tubes, esophageal rupture, gas into the mediastinum; iatrogenic trauma, such as endoscopy, tracheotomy, can also allow gas to spread into the subcutaneous diffusion To the mediastinum, causing mediastinal emphysema. The severity of the symptoms of mediastinal emphysema may vary depending on the amount of gas and whether there is a secondary infection. Simple mediastinal emphysema may have shortness of breath, chest tightness, and poor breathing. Due to trauma associated with high-pressure pneumothorax, internal bleeding may have difficulty breathing, and even life-threatening.

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