Sangani Niravkumar K, Naliath Santosh Mathew
Department of Cardiothoracic Surgery, Ahalia Hospital, Abu Dhabi, United Arab Emirates.
Indian J Thorac Cardiovasc Surg. 2020 Nov;36(6):639-642. doi: 10.1007/s12055-020-01004-0. Epub 2020 Jul 21.
We describe a case of vigorous cough-induced left intercostal artery rupture with partial diaphragmatic tear in a 60-year-old obese male with chronic obstructive pulmonary disease. He presented with left hemothorax, a rapidly spreading chest and abdominal wall hematoma, and progression of anemia. Computed tomography (CT) scan revealed a bleeding focus from the left 8th intercostal artery. CT-guided surface marking of the bleeding point was done over the chest wall. The patient underwent open thoracotomy with drainage of clotted hemothorax and ligation of bleeding intercostal artery. Incidentally, a partial diaphragm tear was detected during the surgery which was repaired. The combined presentation of cough-induced intercostal artery rupture with partial diaphragm tear is not reported earlier. Awareness of these co-existing pathologies can facilitate timely diagnosis and appropriate life-saving management.
我们描述了一例60岁患有慢性阻塞性肺疾病的肥胖男性因剧烈咳嗽导致左肋间动脉破裂并伴有部分膈肌撕裂的病例。他表现为左侧血胸、迅速蔓延至胸壁和腹壁的血肿以及贫血加重。计算机断层扫描（CT）显示左第8肋间动脉有出血点。在胸壁上进行了CT引导下出血点的体表标记。患者接受了开胸手术，排出了凝固的血胸并结扎了出血的肋间动脉。术中偶然发现部分膈肌撕裂并进行了修复。咳嗽诱发的肋间动脉破裂合并部分膈肌撕裂的联合表现此前未见报道。认识到这些并存的病理情况有助于及时诊断和采取适当的挽救生命的治疗措施。
