Choudhry Muhammad Saad, Sultan Anum, Hassan Maria, Ali Muhammad, Zaidi Syed Muhammad Hussain
General Surgery, Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK.
Radiology, Dr. Ziauddin Hospital, Karachi, PAK.
Cureus. 2020 Aug 31;12(8):e10151. doi: 10.7759/cureus.10151.
Chest wall hematoma commonly occurs as a result of blunt thoracic trauma. We report an intriguing case of spontaneous lateral chest wall hematoma that presented with right scapular swelling and tenderness on palpation having hemodynamic instability without any prior history of recent trauma or surgery. Chest x-ray and ultrasound were carried out at the time of admission to evaluate the swelling, followed by contrast-enhanced CT (CECT) of the chest to identify and localize the bleeder. Transcatheter arterial embolization (TAE) of the intercostal artery was performed to treat the condition successfully. CECT is found to be vitally important in localizing bleeders. Other possible options include exploratory thoracotomy, video-assisted thoracic surgery (VATS) exploration, and angiography.
胸壁血肿通常因钝性胸部创伤而发生。我们报告了一例有趣的自发性胸壁外侧血肿病例,表现为右肩胛肿胀且触诊时有压痛,伴有血流动力学不稳定,且无近期创伤或手术史。入院时进行了胸部X光和超声检查以评估肿胀情况,随后进行胸部增强CT(CECT)以识别并定位出血点。对肋间动脉进行了经导管动脉栓塞术(TAE),成功治疗了该病症。发现CECT在定位出血点方面至关重要。其他可能的选择包括开胸探查、电视辅助胸腔镜手术(VATS)探查和血管造影。