Muthuswamy P, Samuel J, Mizock B, Dunne P
Division of Pulmonary Medicine, Cook County Hospital, Chicago 60612.
Chest. 1993 Aug;104(2):637-9. doi: 10.1378/chest.104.2.637.
Intercostal artery aneurysms can be of congenital, posttraumatic, or mycotic type. Intercostal arterial aneurysmal bleeding can be brisk enough to lead into shock or sudden death. Bleeding through chest tubes has been reported due to various causes; it is commonly due to injury to intercostal or pulmonary vessels and is occasionally due to leaking aortic aneurysms. We describe a patient who had development of repeated episodes of brisk bleeding through an empyema chest tube leading to shock episodes requiring resuscitations. After extensive search, the bleeding source was found to be an intercostal artery aneurysm. Transcatheter embolization of that intercostal artery with absorbable gelatin sponge (Gelfoam) was successful in obliterating the blood flow to the aneurysm and in preventing further bleeding.
肋间动脉瘤可分为先天性、创伤后性或霉菌性。肋间动脉动脉瘤出血可能很迅猛，足以导致休克或猝死。据报道，由于各种原因，胸腔引流管会出现出血情况；常见原因是肋间血管或肺血管损伤，偶尔也因主动脉瘤渗漏所致。我们描述了一名患者，其通过脓胸胸腔引流管反复出现迅猛出血，导致休克发作，需要进行复苏。经过广泛排查，发现出血源是一个肋间动脉瘤。用可吸收明胶海绵（明胶海绵）对该肋间动脉进行经导管栓塞，成功阻断了动脉瘤的血流，防止了进一步出血。
