Yoshida Chihiro, Yamamoto Yutarou, Sasa Souichirou, Matsuoka Hisashi, Hokimoto Norihiro, Yamai Hiromichi, Ohnishi Kazuhisa, Tanida Nobuyuki, Fujishima Noriaki, Hamaguchi Nobumasa, Ichikawa Youichi, Tano Kazutoshi
Division of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan.
Kyobu Geka. 2015 Aug;68(9):789-92.
A 94-year-old woman was admitted to our hospital with sudden onset of chest pain without any episode of trauma. Computed tomography(CT) revealed left massive pleural effusion and extravasation of contrast medium from the side chest wall to the back. Neither aortic aneurysm nor dissection was evident. During the investigation, the patient went into hypovolemic shock. Hemothorax due to bleeding from an intercostal artery was diagnosed, and emergency surgery was performed. A 1-mm hole was detected in the descending aorta, and closed by a single suture. The final diagnosis was spontaneous rupture of the thoracic aorta. Three-dimensional CT (3D-CT), reconstructed postoperatively, revealed extravasation of the contrast medium from the descending aorta. The postoperative course was satisfactory, and the patient was discharged on the 20th postoperative day. 3D-CT may be useful for identifying the source of bleeding in such cases.
一名94岁女性因突发胸痛入院，无任何外伤史。计算机断层扫描（CT）显示左侧大量胸腔积液，造影剂从侧胸壁外渗至背部。未见主动脉瘤或夹层。在检查过程中，患者出现低血容量性休克。诊断为肋间动脉出血导致血胸，并进行了急诊手术。在降主动脉发现一个1毫米的洞，用单根缝线缝合。最终诊断为胸主动脉自发性破裂。术后重建的三维CT（3D-CT）显示造影剂从降主动脉外渗。术后病程顺利，患者于术后第20天出院。3D-CT可能有助于识别此类病例的出血来源。
