CHAPTER 8 The widened mediastinum
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.
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