2018 Volume 32 Issue 4 Pages 469-474
A 72-year-old woman forcefully struck the front of her chest on a steering wheel in a traffic accident and was transported to our hospital by ambulance. Upon arrival, a chest radiograph showed a left-sided hemothorax, and she underwent chest tube intubation. Computed tomography showed no obvious leakage of the contrast medium, and the blood pressure was normal. Three hours after hospitalization, her vital signs indicated that she had developed shock, and a chest radiograph showed a massive hemothorax with a right-sided mediastinal shift. An emergency operation was performed, and following the thoracotomy, 2,000 g of hematoma was removed from her pleural cavity with recovery of her blood pressure. Rupture of an abnormal vessel that showed cord-like adhesions to the apical parietal pleura was observed to be the source of bleeding. We clipped this blood vessel to ensure hemostasis. No other bleeding sites were identified.
Conclusion: We treated a patient with traumatic hemothorax, which is commonly referred to as tension hemothorax. Abnormal vessel rupture secondary to cord adhesions with the parietal pleura is rare in patients presenting with massive traumatic hemothorax; however, clinicians should be mindful of this possibility in clinical practice.
