Bilateral Internal Mammary Artery Injury without Fracture of the Chest Following a Traffic Accident

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Injury of the thoracic aorta is the most common arterial injury associated with a widened mediastinum on a chest radiograph after trauma. Injury to the internal mammary artery (IMA) due to blunt trauma is rare. Patients with IMA injury usually have a fracture of the chest. We report a patient with bilateral IMA owing to blunt injury caused by a traffic accident. However, the patient did not have a fracture of his chest. Nausea and vomiting were present because the oesophagus and heart were compressed by a mediastinal haematoma. X-ray and multidetector computed tomography are valuable for identification of IMA injury but the most effective tool is angiography.