Okamura Kazuya, Yoshida Rika, Yoshizako Takeshi, Kitagaki Hajime
Department of Radiology, Shimane University, Faculty of Medicine, Izumo, Shimane, Japan.
Acta Radiol Open. 2022 Apr 22;11(4):20584601221097468. doi: 10.1177/20584601221097468. eCollection 2022 Apr.
Hemothorax is an urgent condition, and its accurate diagnosis and the identification of the cause are important. Herein, we report a case of a 74-year-old man with end-stage renal disease who was presented with high-concentration pleural effusion owing to residual contrast medium. The case required differentiation from hemothorax owing to an aortic dissection and its rupture. In patients with end-stage renal disease, noncontrast-enhanced computed tomography after contrast-enhanced computed tomography may result in high-concentration pleural effusion owing to the existence of residual contrast medium. This realization is important to determine whether high-concentration pleural effusion symptoms reflect an urgent hemothorax case possibly related to an imminent rupture of an aortic aneurysm or intrathoracic penetration of aortic dissection, and whether invasive procedures, such as thoracentesis, ought to be avoided.
血胸是一种急症，准确诊断并确定病因很重要。在此，我们报告一例74岁终末期肾病男性患者，因残留造影剂出现高浓度胸腔积液。该病例需要与主动脉夹层及其破裂导致的血胸相鉴别。对于终末期肾病患者，增强计算机断层扫描（CT）后进行非增强CT可能会因残留造影剂而导致高浓度胸腔积液。认识到这一点对于确定高浓度胸腔积液症状是否反映可能与主动脉瘤即将破裂或主动脉夹层胸腔内穿透有关的急症血胸病例，以及是否应避免诸如胸腔穿刺等侵入性操作很重要。
