Massive Hemothorax Caused by Intercostal Artery Bleeding: Selective Embolization May Be an Alternative to Thoracotomy in Selected Patients

Abstract

Massive hemothorax is an indication for thoracotomy. We report a case of an 85-year-old debilitated patient, in whom massive hemorrhage from an actively bleeding intercostal artery was controlled by angiographic embolization. Angiographic embolization proved to be an effective alternative to thoracotomy in this patient, thus avoiding numerous postoperative complications and high mortality. Massive bleeding from an intercostal artery should be considered an indication for angiographic embolization in selected patients.

Key words

Embolization - chest trauma - intercostal artery bleeding - hemothorax

References

• 1 Richardson J D. Indications for thoracotomy in thoracic trauma.  Curr Surg. 1985;  42 361-364
• 2 Richardson J D, Miller F B. Injury to the lung and pleura. Feliciano DV, Moore EE, Mattox KL Trauma. Stamford, CT; Appleton & Lange 1995: 387-407
• 3 Muthuswamy P, Samuel J, Mizock B, Dunne P. Recurrent massive bleeding from an intercostal artery aneurysm through an empyema chest tube.  Chest. 1993;  104 637-639
• 4 Carrillo E H, Heniford B T, Senler S O. et al . Embolization therapy as an alternative to thoracotomy in vascular injuries of the chest wall.  Am Surg. 1998;  64 1142-1148
• 5 Matsumoto H, Suzuki M, Kamata T, Kanno M. Intercostal artery injuries treated by angiographic embolization: case report.  J Trauma. 1998;  44 392-393
• 6 Lampmann L E, Tjan T G. Embolization therapy in haemoptysis.  Eur J Radiol. 1994;  18 15-19