Abstract
A 26-year-old man who had a fall from a bicycle visited a nearby hospital. Chest radiography and computed tomography (CT) showed fractures of the left sixth and seventh ribs, but hemothorax and pneumothorax were not found. On the second day after the injury, he was discharged because no abnormalities were observed on a chest radiography. However, on the evening of the same day, he experienced sudden exacerbation of left chest pain and visited the previous hospital. Chest radiography and CT scan showed left massive hemothorax. He was then transferred to our hospital. When a thoracic drain was placed in our hospital, 800 ml of bloody effusion was confirmed. The systolic blood pressure was as low as 80 mmHg, and emergency surgery was performed with the diagnosis of hemorrhagic shock. Based on thoracoscopic observation, a laceration was found in the diaphragm just below the camera port, and it was confirmed to be the bleeding site. The laceration was sutured, and the surgery was completed with hemostasis. The postoperative course was uneventful, and he was discharged 5 days after the surgery. Bleeding due to diaphragm rupture should be considered as a possible cause of delayed hemothorax after a trauma.
