A late mediastinal complication of EBUS-TBNA: Case report and review of the literature

Minimally invasive procedures such as bronchoscopy are preferred to mediastinoscopy, given that the target is reachable being adjacent to the airways. Direct visualization of the puncture site is also preferable. Thus, indication for bronchoscopy was clear and the patient was scheduled ABSTRACT Mediastinal bleeding and development of hematoma (hemomediastinum) can rarely occur after TBNA (transbronchial needle aspiration). We report on a case of a 74-year-old man who developed a late post EBUS-TBNA (endobronchial ultrasound guided transbronchial needle aspiration) mediastinal hematoma attributed to supra-normal INR due to antibiotic treatment and anticoagulants following bronchoscopy. To the best of our knowledge, in the current literature there are only a few cases of mediastinal bleeding following transbronchial or transesophageal puncture and most are not related with coagulation abnormalities. This is the second case reported with late onset mediastinal hematoma post EBUS-TBNA and the first to be attributed to combined amoxycillin treatment and coumarin anticoagulants.