A case of a ruptured intercostal artery associated with neurofibromatosis type 1 (NF-1)

Abstract

A 76-year-old woman was admitted to our hospital for sudden right chest pain. CT showed massive right hemothorax with extravasation from the right fifth intercostal artery. Although emergency thoracotomy was performed, surgical hemostasis was difficult because of the fragility of vessels and tissues. Bleeding was stopped by direct pressure with a tissue sealing sheet. Transcatheter arterial embolization (TAE) was performed immediately, as an additional hemostasis procedure. The patient was subsequently diagnosed with neurofibromatosis type 1 (NF-1) on further examination during the postoperative course. We should recognize that surgical intervention is very difficult and TAE is a more beneficial procedure for hemothorax with NF-1.