Afonso Catarina, Pereira Jorge, Gil-Agostinho Alfredo, Casimiro Carlos
General Surgery, Centro Hospitalar Tondela Viseu EPE, Viseu, Portugal
General Surgery, Centro Hospitalar Tondela Viseu EPE, Viseu, Portugal.
BMJ Case Rep. 2020 Feb 13;13(2):e233242. doi: 10.1136/bcr-2019-233242.
Spontaneous rupture of an intercostal artery is exceptionally rare. It can be complicated by haemothorax, haematoma and/or retroperitoneal haemorrhage, which contributes to its morbidity and mortality. The authors report a case of a 76-year-old patient who was referred to the emergency department for pain associated with the appearance of a mass with progressive growth for 2 days in the right subscapular region. The patient had no previous history of trauma, ecchymosis or noticeable skin changes. History included the use of acetylsalicylic acid and a history of heart failure, as well as haemodialysis due to stage 5 chronic renal disease. CT scan showed an active haemorrhage from an artery in the fifth intercostal space. Embolisation was performed with microspheres and microcoils. No complications or recurrent bleeding was observed. Spontaneous rupture of an intercostal artery is rare, but it is an emergency requiring immediate diagnosis and intervention.
肋间动脉自发性破裂极为罕见。它可能并发血胸、血肿和/或腹膜后出血,这导致了其发病率和死亡率。作者报告了一例76岁患者,因右肩胛下区域出现渐进性生长2天的肿块并伴有疼痛而被转诊至急诊科。患者既往无创伤、瘀斑或明显皮肤变化史。病史包括服用乙酰水杨酸、有心力衰竭病史以及因5期慢性肾病进行血液透析。CT扫描显示第五肋间空间的动脉有活动性出血。采用微球和微线圈进行了栓塞治疗。未观察到并发症或复发性出血。肋间动脉自发性破裂虽罕见,但却是一种需要立即诊断和干预的急症。