Widening of the mediastinum following a sternal fracture.

Int J Clin Pract

Accident & Emergency Department, Stockport Infirmary, Greater Manchester, UK.

Published: June 1997

Sternal fractures, once thought of as uncommon, occur with increasing frequency, parallelling the incidence of motor vehicle accidents. A fractured sternum can produce a widening of the mediastinum even in the absence of an aortic injury. The Advanced Trauma Life Support course teaches that a widening of the mediastinum after blunt chest injury is an indication for aortography. In this case report we recommend computerised axial tomography (CT) scan of the chest as the investigation of choice in the non-hypotensive patient who has sustained a fractured sternum after a blunt chest trauma, and who has widening of the mediastinum on the chest X-ray, with no other radiological features suggesting traumatic aortic rupture.

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