Abstract
A case of hemothorax in a 15-year-old girl secondary to injury to the diaphragm caused by a rib deformity is reported. The patient has multiple osteochondroma inherited as an autosomal dominant disease. She was admitted with left chest pain. Deformity was also found in the scapulas. Roentgenograms showed pleural effusion, and a pleural tap revealed a hemothorax. Pneumothorax was not found. Thoracic computed tomographic (CT) scan demonstrated no clear reason for the hemothorax, so thoracoscopic examination was performed. In the pleural cavity, about 900 ml of bloody effusion and spicula of some ribe were found. Bleeding was due to injury of the diaphragm by spicula of the 7th rib arising from the costochondral joint. This part of the rib was resected under mini-thoracotomy, and the injured part of the diaphragm was sutured under direct view. Rescted specimen and clinical findings led to a diagnosis of hereditary multiple exostoses. Thoracoscopic examination was useful for definite diagnosis of the cause of hemothorax and source of bleeding.
