2005 Volume 19 Issue 4 Pages 616-621
A 18-year-old man consulted his home doctor with complaints of hemosputum, fever, and dyspnea. Although these symptoms improved after treatment with antibiotics, his chest CT demonstrated a tumor-like shadow in the right lower lobe (RLL), pleural effusion, and an anomalous vessel arising from the descending thoracic aorta and coursing posteriorly into the RLL. He was referred to our hospital for surgical treatment. Aortography showed this anomalous vessel in the early phase and the inferior pulmonary vein in the late phase. Intralobar sequestration was diagnosed and right thoracotomy was performed. Massive bloody effusion was present in the pleural cavity. The basal segment had multiple cysts filled with blood clots, one of which had ruptured. The high pressure in the cyst produced by the bleeding was considered to have caused the rupture, which resulted in the massive hemothorax. A review of the literature revealed that massive hemothorax is a rare but sometimes life-threatening complication associated with pulmonary sequestration.
