Park C, Lee J. Massive hemothorax due to intercostal arterial bleeding after percutaneous catheter removal in a multiple-trauma patient: A case report. World J Clin Cases 2021; 9(32): 9942-9947 [PMID: 34877334 DOI: 10.12998/wjcc.v9.i32.9942]
Corresponding Author of This Article
Jeongwoo Lee, MD, Assistant Professor, Division of Trauma Surgery, Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, 1035 Dalgubeoldaero, Dalseogu, Daegu 42601, South Korea. johanleejw@gmail.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 16, 2021; 9(32): 9942-9947 Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.9942
Massive hemothorax due to intercostal arterial bleeding after percutaneous catheter removal in a multiple-trauma patient: A case report
Chanhee Park, Jeongwoo Lee
Chanhee Park, Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu 42601, South Korea
Jeongwoo Lee, Division of Trauma Surgery, Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu 42601, South Korea
Author contributions: Park C and Lee J were the patient’s physicians in charge, reviewed the literature and contributed to manuscript drafting; Park C analyzed and interpreted the imaging findings; Park C and Lee J reviewed the literature and drafted the manuscript; and all authors issued final approval for the version to be submitted.
Informed consent statement: The retrospective study was approved by the institutional review board of the Keimyung University Hospital (approval number: DSMC 2021-06-021). Data were collected and analyzed in an ethical manner while protecting the patients’ right to privacy. The requirement for informed consent was waived.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jeongwoo Lee, MD, Assistant Professor, Division of Trauma Surgery, Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, 1035 Dalgubeoldaero, Dalseogu, Daegu 42601, South Korea. johanleejw@gmail.com
Received: June 14, 2021 Peer-review started: June 14, 2021 First decision: June 25, 2021 Revised: June 30, 2021 Accepted: September 15, 2021 Article in press: September 15, 2021 Published online: November 16, 2021
Abstract
BACKGROUND
Intercostal arterial bleeding is unusual complication of percutaneous chest procedures. However, intercostal arterial bleeding is likely to result in critical complications such as abnormalities in vital signs, hypovolemic shock, and death due to massive bleeding. Therefore, it is very important to establish the diagnosis of intercostal arterial bleeding and to initiate treatment.
CASE SUMMARY
We report a case in which a 59-year-old woman who was hospitalized at intensive care unit with multiple trauma had a massive hemothorax after the removal of a percutaneous catheter. She sustained a refractory right pleural effusion due to biloma caused by a traumatic injury to the liver, despite persistent intraperitoneal drainage. As a result, atelectasis persisted in the dependent portion of the right lung. Therefore, we performed right percutaneous catheter drainage (8.5-F pigtail catheter) for pleural effusion drainage at the 7th intercostal space. After percutaneous catheter removal, portable chest radiography and vital signs of the patient assisted in establishing a diagnosis of intercostal arterial bleeding. Intercostal arterial bleeding was also confirmed using transarterial angiography; and embolization was performed. The patient’s condition progressively improved, and no further intervention was required.
CONCLUSION
Massive hemothorax is a rare complication of percutaneous catheter removal. Clinicians should carefully examine and diagnose patients to improve prognosis. And interventional selective angiography may be a feasible and minimally invasive treatment for intercostal arterial bleeding control.
Core Tip: Intercostal arterial bleeding might cause massive hemothorax that is a rare complication after percutaneous catheter removal. However, if patients are early diagnosed and managed, prognosis can be highly improved. Interventional selective angiography may be a feasible and minimally invasive option for bleeding control.
