Okamoto Keigo, Ichinose Masutaro, Hanaoka Jun
Department of General Thoracic Surgery, Shiga University of Medical Science, Otsu, Japan.
Department of General Thoracic Surgery, Rakuwakai Otowa Hospital, Kyoto, Japan.
SAGE Open Med Case Rep. 2018 Dec 20;6:2050313X18819617. doi: 10.1177/2050313X18819617. eCollection 2018.
Traumatic hemothorax is usually caused by thoracic organ damage. Cases of atypical bleeding sources may be difficult to diagnose. Here we present two surgical cases of vertebral fracture that caused hemothorax. Case 1: an 81-year-old man was admitted to our hospital after a fall. Computed tomography showed right hemothorax without rib fractures. He suddenly developed shock and intrathoracic hemorrhage. Thoracotomy revealed the bleeding source as a transverse laceration in T7. Case 2: an 83-year-old woman fell on her back and was admitted. Computed tomography indicated an L1 vertebral fracture. A few days later, she suddenly developed a right hemothorax. An intrathoracic hemorrhage was sustained after transcatheter embolization. Thoracotomy revealed a diaphragmatic rupture. Total cross-fracture of the vertebral body solely caused the hemothorax. If bleeding source is unclear in elderly patients, this etiology should be considered. We saved both patients by performing spinal fusion surgery at the appropriate time.
创伤性血胸通常由胸部器官损伤引起。非典型出血源的病例可能难以诊断。在此，我们介绍两例因椎体骨折导致血胸的手术病例。病例1：一名81岁男性在跌倒后入院。计算机断层扫描显示右侧血胸，无肋骨骨折。他突然出现休克和胸腔内出血。开胸手术显示出血源为T7椎体的横向撕裂伤。病例2：一名83岁女性背部着地跌倒后入院。计算机断层扫描显示L1椎体骨折。几天后，她突然出现右侧血胸。经导管栓塞后仍有胸腔内出血。开胸手术显示膈肌破裂。椎体完全横断骨折单独导致了血胸。如果老年患者的出血源不明，应考虑这种病因。我们通过在适当的时候进行脊柱融合手术挽救了这两名患者。
