Abstract
A 72-year-old man stabbed his left chest 20 times by himself with an engraving knife was brought into our hospital by emergency service. His vital signs were stable. The stab wounds were superficial. No bleeding from the stab wounds was confirmed. Chest CT scan showed an anterior mediastinal hematoma and massive left hemothorax. Emergency angiography revealed no active bleeding from the left internal thoracic artery and the left intercostal artery. The origin of the bleeding was unclear, but the 2 ∼ 4 intercostal arteries were suspected as the bleeding sites. We placed a thoracostomy tube into the left thoracic cavity due to the left hemothorax. Plain chest CT scan on the 7th day showed improvement of the anetrior mediastinal hematoma and left hemothorax. He was discharged from our hospital without any complications 10 days after the injury. He was seen at the hospital again because of breathlessness 18 days after the injury, when chest enhanced CT scan showed a 5cm-sized pseudoaneurysm of the left internal thoracic artery and increased left pleural effusion. Arterial embolization was performed. Chest CT scan on the 11th day after the embolization showed no abnormal findings, and the patient was transferred to the previous hospital.
