Abstract
A 20-year-old female was admitted to our emergency room with an acute right back pain followed by progressive dyspnea. CT scan showed right-sided pleural effusion and pulmonary collapse with mediastinal shift. Based on the result, she was diagnosed with spontaneous hemopneumothorax. Seven hundred milliliters of bloody effusion were drawn out through a chest drain. Her vital signs were normal in spite of the bleeding. Further diagnosis by bronchial arteriography revealed the presence of abnormal vessel near the second right intercostal artery which branched from right bronchial artery. Subsequent embolization of the vessel with Histoacryl® stopped the bleeding as indicated by clear effusion. Three days after the procedure, 400 mL of intrathoracic remnant hematoma was removed by performing video assisted thoracic surgery. During surgery, no sign of bleeding was detected around the apex of pleural cavity where cord-like tissue connected with parietal pleura. Hence we confirmed that the abnormal vessel was the responsible lesion. Given the ideal postoperative recovery course, she was discharged on the 8th postoperative day, especially at the case that does not have a shock or the high-risk case under thoracoscopic surgery.
