Mediastinal and Retropharyngeal Hemorrhage

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Abstract
Upper mediastinal and retropharyngeal hemorrhage complicated retrograde left ventricular catheterization in two patients. The clinical signs of shock associated with upper airway obstruction were dramatic and presented diagnostic problems. In one patient, recognition of an enlarging neck circumference and visual examination of the oral pharynx aided in establishing the proper diagnosis, which was later confirmed by x-ray films of the chest and lateral aspects of the neck. Both patients were successfully treated with blood replacement and maintenance of an adequate airway. Anticoagulant therapy may be a cause of serious hemorrhage following arterial perforation.