case_images: PMC11650203_01
case_images: (A) Precontrast CT scans in the sagittal plane (A) and axial plane (B-D) depict an extensive hematoma extending from the neck to the mediastinum, surrounding the esophagus (C, D).
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case_images: Initial precontrast CT showed medium- to high-density lesions extending from the neck to the mediastinum (Fig. 1A). The neck lesion was located dorsal to the right thyroid gland lobe (Fig. 1B), and in the mediastinum, it surrounded the esophagus (Fig. 1C, D).
case_images: (A, B) Dynamic contrast-enhanced CT scans show extravasation of contrast media (arrowhead) posterior to the right lobe of the thyroid gland (white arrowhead), showing expansion. (C) A volume-rendering image shows the right inferior thyroid artery (white arrow) and the adjacent extravasation (white arrowhead) highlighting their proximity.
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case_images: Subsequent dynamic contrast-enhanced CT scans revealed contrast media extravasation dorsal to the right thyroid gland lobe (Fig. 2A), suggesting possible rupture of a parathyroid adenoma or the inferior thyroid artery. A hypodense nodule adjacent to the extravasation, presumed to be the right inferior parathyroid gland, did not show contrast enhancement (Fig. 2B). The nearby right inferior thyroid artery was suspected to be the source of the hemorrhage (Fig. 2C), leading to a diagnosis of extensive cervical and mediastinal hematoma caused by rupture of this artery.
case_images: (A) An arteriogram of the right subclavian artery showing the right inferior thyroid artery branching off from the thyrocervical trunk. (B) An arteriogram of the right inferior thyroid artery depicts the site of extravasation. (C) An arteriogram of the thyrocervical trunk shows the occluded inferior thyroid artery.
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case_images: A 4Fr catheter was introduced into the right subclavian artery, and an angiogram confirmed extravasation from the right inferior thyroid artery (Fig. 3B). The artery was embolized using a gelatin sponge (Fig. 3C).