Report of a rare case: occult hemothorax due to blunt trauma without obvious injury to other organs

Traumatic hemothorax commonly occurs accompanied by organ damage, such as rib fractures, lung injury and diaphragm rupture. Our reported patient was a 61-year-old man who fell down from a stepladder about 1 meter in height, resulting in a heavy blow to the left abdomen. He consulted a clinic because...

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Bibliographic Details
Published inJournal of cardiothoracic surgery Vol. 8; no. 1; p. 205
Main Authors Ogawa, Fumihiro, Naito, Masahito, Iyoda, Akira, Satoh, Yukitoshi
Format Journal Article
LanguageEnglish
Published England BioMed Central Ltd 01.11.2013
BioMed Central
Subjects
Blunt trauma
Care and treatment
Case Report
Case studies
CT imaging
Diagnosis
Hemothorax - etiology
Humans
Lung diseases
Male
Middle Aged
Patient outcomes
Risk factors
Thoracotomy
Torso - blood supply
Torso - injuries
Wounds, Nonpenetrating - physiopathology
Japan
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Summary:Traumatic hemothorax commonly occurs accompanied by organ damage, such as rib fractures, lung injury and diaphragm rupture. Our reported patient was a 61-year-old man who fell down from a stepladder about 1 meter in height, resulting in a heavy blow to the left abdomen. He consulted a clinic because of left chest pain the next day and was transported to the emergency center of our hospital on diagnosis of hemothorax with hemorrhagic shock.On computed tomography scanning with contrast medium, left hemothorax without rib fracture, diaphragm rupture or obvious organ injury was evident. We found only bleeding to the thoracic space from a branch of the left inferior phrenic artery without involvement of the abdomen. The patient underwent percutaneous angiography and embolization for hemostasis, and subsequently thoracotomy in order to check the active bleeding and remove the hematoma to improve respiratory. As thoracotomy findings, we found damage of a branch of the left inferior phrenic artery to the thoracic space without diaphragm rupture, and sutured the lesion. Such active intervention followed by surgical procedures was effective and should be considered for rare occurrences like the present case. We must consider not only traumatic diaphragm rupture, but also vascular damage by pressure trauma as etiological factors for hemothorax.
Bibliography:ObjectType-Case Study-2
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ISSN:1749-8090
1749-8090
DOI:10.1186/1749-8090-8-205