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Widened mediastinum

MedGen UID:
677085
•Concept ID:
C0746459
•
Finding
Synonym: Mediastinal widening
SNOMED CT: Mediastinal widening (363646005); Widened mediastinum (363646005)
 
HPO: HP:0034501

Definition

Abnormal increase in the width of the mediastinum, often defined as being greater than 6 to 8 cm. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVWidened mediastinum

Professional guidelines

PubMed

Inhalational anthrax: threat, clinical presentation, and treatment.
Henry L
J Am Acad Nurse Pract 2001 Apr;13(4):164-8; quiz 169-70. doi: 10.1111/j.1745-7599.2001.tb00241.x. PMID: 11930529
Diagnosis and management of blunt great vessel trauma.
von Segesser LK, Fischer A, Vogt P, Turina M
J Card Surg 1997 Mar-Apr;12(2 Suppl):181-6; discussion 186-92. PMID: 9271744
Thoracic aortic dissection or aneurysm: clinical presentation, diagnostic imaging and initial management in a tertiary referral centre.
Hennessy TG, Smith D, McCann HA, McCarthy C, Sugrue DD
Ir J Med Sci 1996 Oct-Dec;165(4):259-62. doi: 10.1007/BF02943084. PMID: 8990649

Recent clinical studies

Etiology

Blunt Traumatic Aortic Injury in the Pan-scan Era.
Yu L, Baumann BM, Raja AS, Mower WR, Langdorf MI, Medak AJ, Anglin DR, Hendey GW, Nishijima D, Rodriguez RM
Acad Emerg Med 2020 Apr;27(4):291-296. Epub 2019 Dec 30 doi: 10.1111/acem.13900. PMID: 31811732
Initial chest X-ray in multiple trauma patients: Still works!
Koci J, Kocova E, Hyspler R, Lochman P, Berkova J, Trlica J, Dedek T
Neuro Endocrinol Lett 2019 Dec;40(7-8):305-307. PMID: 32304365
Blunt Trauma: What Is Behind the Widened Mediastinum on Chest X-Ray (CXR)?
Vasileiou G, Qian S, Al-Ghamdi H, Pace D, Rattan R, Mulder M, Namias N, Dante Yeh D
J Surg Res 2019 Nov;243:23-26. Epub 2019 May 28 doi: 10.1016/j.jss.2019.04.079. PMID: 31151033
Aortic dissection.
Prisant LM, Nalamolu VR
J Clin Hypertens (Greenwich) 2005 Jun;7(6):367-71. doi: 10.1111/j.1524-6175.2005.04116.x. PMID: 16088302Free PMC Article
Imaging of thoracic aortic dissection.
Vu FH, Young N, Soo YS
Australas Radiol 1994 Aug;38(3):170-5. doi: 10.1111/j.1440-1673.1994.tb00167.x. PMID: 7945107

Diagnosis

Misdiagnosis of aortic dissection: A systematic review of the literature.
Lovatt S, Wong CW, Schwarz K, Borovac JA, Lo T, Gunning M, Phan T, Patwala A, Barker D, Mallen CD, Kwok CS
Am J Emerg Med 2022 Mar;53:16-22. Epub 2021 Dec 4 doi: 10.1016/j.ajem.2021.11.047. PMID: 34968970
Ptosis and Miosis Associated with Fibrosing Mediastinitis.
Ahmed S, Hameed M, Thomas MM, Syed KS, Haq IU, AlAbbas A
Am J Case Rep 2021 Jan 12;22:e927556. doi: 10.12659/AJCR.927556. PMID: 33431787Free PMC Article
Blunt Traumatic Aortic Injury in the Pan-scan Era.
Yu L, Baumann BM, Raja AS, Mower WR, Langdorf MI, Medak AJ, Anglin DR, Hendey GW, Nishijima D, Rodriguez RM
Acad Emerg Med 2020 Apr;27(4):291-296. Epub 2019 Dec 30 doi: 10.1111/acem.13900. PMID: 31811732
Aortic dissection.
Prisant LM, Nalamolu VR
J Clin Hypertens (Greenwich) 2005 Jun;7(6):367-71. doi: 10.1111/j.1524-6175.2005.04116.x. PMID: 16088302Free PMC Article
Anthrax pneumonia.
Penn CC, Klotz SA
Semin Respir Infect 1997 Mar;12(1):28-30. PMID: 9097373

Therapy

Clinical Examination for Acute Aortic Dissection: A Systematic Review and Meta-analysis.
Ohle R, Kareemi HK, Wells G, Perry JJ
Acad Emerg Med 2018 Apr;25(4):397-412. Epub 2018 Jan 24 doi: 10.1111/acem.13360. PMID: 29265487
The inadvertent administration of anticoagulants to ED patients ultimately diagnosed with thoracic aortic dissection.
Davis DP, Grossman K, Kiggins DC, Vilke GM, Chan TC
Am J Emerg Med 2005 Jul;23(4):439-42. doi: 10.1016/j.ajem.2004.10.010. PMID: 16032607
Inhalational anthrax: threat, clinical presentation, and treatment.
Henry L
J Am Acad Nurse Pract 2001 Apr;13(4):164-8; quiz 169-70. doi: 10.1111/j.1745-7599.2001.tb00241.x. PMID: 11930529
Anthrax pneumonia.
Penn CC, Klotz SA
Semin Respir Infect 1997 Mar;12(1):28-30. PMID: 9097373
Aortic dissection: a statistical analysis of the usefulness of plain chest radiographic findings.
Jagannath AS, Sos TA, Lockhart SH, Saddekni S, Sniderman KW
AJR Am J Roentgenol 1986 Dec;147(6):1123-6. doi: 10.2214/ajr.147.6.1123. PMID: 3490744

Prognosis

Blunt Traumatic Aortic Injury in the Pan-scan Era.
Yu L, Baumann BM, Raja AS, Mower WR, Langdorf MI, Medak AJ, Anglin DR, Hendey GW, Nishijima D, Rodriguez RM
Acad Emerg Med 2020 Apr;27(4):291-296. Epub 2019 Dec 30 doi: 10.1111/acem.13900. PMID: 31811732
Aortic dissection.
Prisant LM, Nalamolu VR
J Clin Hypertens (Greenwich) 2005 Jun;7(6):367-71. doi: 10.1111/j.1524-6175.2005.04116.x. PMID: 16088302Free PMC Article
Thymic carcinoid tumours.
Parra I, Remacha A, Costilla S, Calderón JA
Can Respir J 2002 May-Jun;9(3):215-6. doi: 10.1155/2002/681807. PMID: 12068342
Inhalational anthrax: threat, clinical presentation, and treatment.
Henry L
J Am Acad Nurse Pract 2001 Apr;13(4):164-8; quiz 169-70. doi: 10.1111/j.1745-7599.2001.tb00241.x. PMID: 11930529
Anthrax pneumonia.
Penn CC, Klotz SA
Semin Respir Infect 1997 Mar;12(1):28-30. PMID: 9097373

Clinical prediction guides

Blunt Traumatic Aortic Injury in the Pan-scan Era.
Yu L, Baumann BM, Raja AS, Mower WR, Langdorf MI, Medak AJ, Anglin DR, Hendey GW, Nishijima D, Rodriguez RM
Acad Emerg Med 2020 Apr;27(4):291-296. Epub 2019 Dec 30 doi: 10.1111/acem.13900. PMID: 31811732
Blunt Trauma: What Is Behind the Widened Mediastinum on Chest X-Ray (CXR)?
Vasileiou G, Qian S, Al-Ghamdi H, Pace D, Rattan R, Mulder M, Namias N, Dante Yeh D
J Surg Res 2019 Nov;243:23-26. Epub 2019 May 28 doi: 10.1016/j.jss.2019.04.079. PMID: 31151033
Clinical Examination for Acute Aortic Dissection: A Systematic Review and Meta-analysis.
Ohle R, Kareemi HK, Wells G, Perry JJ
Acad Emerg Med 2018 Apr;25(4):397-412. Epub 2018 Jan 24 doi: 10.1111/acem.13360. PMID: 29265487
Aortic dissection.
Prisant LM, Nalamolu VR
J Clin Hypertens (Greenwich) 2005 Jun;7(6):367-71. doi: 10.1111/j.1524-6175.2005.04116.x. PMID: 16088302Free PMC Article
Cystic transformation of the rete testis.
Nistal M, Mate A, Paniagua R
Am J Surg Pathol 1996 Oct;20(10):1231-9. doi: 10.1097/00000478-199610000-00009. PMID: 8827030

Recent systematic reviews

Misdiagnosis of aortic dissection: A systematic review of the literature.
Lovatt S, Wong CW, Schwarz K, Borovac JA, Lo T, Gunning M, Phan T, Patwala A, Barker D, Mallen CD, Kwok CS
Am J Emerg Med 2022 Mar;53:16-22. Epub 2021 Dec 4 doi: 10.1016/j.ajem.2021.11.047. PMID: 34968970
Clinical Examination for Acute Aortic Dissection: A Systematic Review and Meta-analysis.
Ohle R, Kareemi HK, Wells G, Perry JJ
Acad Emerg Med 2018 Apr;25(4):397-412. Epub 2018 Jan 24 doi: 10.1111/acem.13360. PMID: 29265487

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