Spontaneous Massive Hemothorax in a Patient with Neurofibromatosis Type 1 with Successful Transarterial Embolization

Hongsakul, Keerati; Rookkapan, Sorracha; Tanutit, Pramot; Pakdeejit, Songklod; Songjamrat, Apiradee; Sungsiri, Jitpreedee

doi:10.3348/kjr.2013.14.1.86

Cited by 22 publications

(27 citation statements)

References 11 publications

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“…The current literature contains reports on ruptures from the subclavian artery, intercostal, vertebral and lumbar arteries, in addition to a couple of reports of bleeding from the thyro-cervical trunk 1 . To the best of our knowledge, this is the first report of a rupture from the left costo-cervical branch to be associated with neurofibromatosis.…”

Section: Discussionmentioning

confidence: 90%

Aneurysmal rupture of the costo-cervical trunk in a patient with neurofibromatosis type 1: A case report

Hoonjan

Thayur

Abu-Own

2014

International Journal of Surgery Case Reports

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INTRODUCTIONRupture of blood vessels associated with neurofibromatosis type 1 (NF-1) is a rare but life threatening complication. We report the first case of an aneurysmal rupture from the costocervical trunk in a NF-1 patient treated by endovascular embolisation.PRESENTATION OF CASEA 43 year-old gentleman with a past medical history of NF-1 presented with sudden onset left sided neck swelling. A computed tomography (CT) revealed a large cervical haematoma, which was causing airway compromise, requiring the patient to be intubated. Percutaneous embolisation of the bleeding vessel from the costo-cervical trunk was performed with successful haemostasis and no immediate complications. A repeat CT scan showed a reduction in the original cervical haematoma. However, six days post embolisation, the patient arrested with complete whiteout of the left hemithorax.DISCUSSIONCT angiography is the gold standard for diagnosis of an aneurysmal rupture in NF-1 patients, and percutaneous embolisation is the preferred modality in patients who are haemodynamically stable due to arterial fragility and high intra operative mortality rates. The increasing haemothorax could be explained by the original cervical haematoma draining down into the pleural space, or the possibility of a new second bleed.CONCLUSIONThis is the first reported episode of bleeding from the costocervical trunk in NF-1 patients. Ruptured aneurysms require urgent CT angiography, if haemodynamically stable, and further input from the vascular surgeons and vascular radiologists.

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Section: Discussionmentioning

confidence: 90%

Aneurysmal rupture of the costo-cervical trunk in a patient with neurofibromatosis type 1: A case report

Hoonjan

Thayur

Abu-Own

2014

International Journal of Surgery Case Reports

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“…Einleitung Der interventionell-radiologische Verschluss von Gefäßen wird als etabliertes Therapieprinzip bei der Behandlung unterschiedlichster Krankheitsbilder eingesetzt. Ein spezielles Anwendungsgebiet ist die notfallmäßige Embolisation von Blutungen aus Interkostalarterien, die häufig iatrogen bedingt sind, jedoch auch nach Thoraxtrauma oderseltenerspontan bei hämorrhagischer Diathese auftreten [1][2][3][4][5]. Während die interventionelle Therapie von traumatisch bedingten Blutungen, z.…”

Section: Interventional Radiological Treatment Of Intercostal Artery unclassified

“…Die Ursachen einer Interkostalarterienblutung sind hauptsächlich iatrogene Gefäßverletzungen [1,2,4], in dem beobachteten Kollektiv am häufigsten durch Pleurapunktionen oder Anlage von Thoraxdrainagen. Seltener sind spontane Blutungen bei hämorrhagischen Diathesen, z.…”

Section: Diskussionunclassified

Interventionell-radiologische Behandlung von Interkostalarterienblutungen – eine retrospektive Analyse

et al. 2017

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Intercostal artery bleedings are potentially fatal injuries. Apart from conservative and surgical treatment options, emergency interventional radiological treatment can also be performed. We report our experience with emergency intercostal artery embolisation. Patients with acute arterial bleedings from the intercostal artery who were treated interventionally over a period of 7 years were identified retrospectively. Technical and clinical success, clinical and procedural parameters as well as overall survival were analysed. Between 2010 and 2017, a total of 27 embolisation procedures was performed in 24 patients (14 male, mean age 65.7 ± 13.9 years). The majority of patients suffered from iatrogenic intercostal artery bleedings (n = 17; 70.1%; especially after thoracocentesis). In five cases, thoracoscopic surgery was attempted prior to intervention but was unsuccessful. Primary technical success was obtained in 25/27 interventions. In two cases, there was re-bleeding via collateral arteries so that re-intervention became necessary (secondary technical success). In 15 cases, secondary surgery after successful interventional treatment was necessary to evacuate the haematoma/haemothorax. Intercostal artery embolisation was clinically successful in 23/24 patients. One patient died despite technically successful embolisation, due to extensive haemothorax. One case of spinal ischaemia was observed as a major complication. Intercostal artery embolisation is an effective interventional radiological emergency measure in patients with acute bleeding and is an alternative to surgical treatment even after attempted, unsuccessful surgery. Because of potentially severe complications, the interventional procedure should be performed by an experienced interventionalist.

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“…3,4 Sistemik olarak optik sinir gliomu, santral sinir sisteminde diğer glial tümörler, osseöz lezyonlar ve endokrin anomaliler izlenebilir. [5][6][7] Becker nevüsü, epidermal ve dermal komponentlerinden oluşan benign kutanöz hamartomdur. Genellikle üst gövde ve omuzlarda gözlenen nevüs, irregüler kenarlı hiperpigmente makülle karakterizedir.…”

Section: Becker Nevüs Ve Hamartomun Eşlik Ettiğiunclassified

“…Altta bulunan dermal defekt nedeni ile üzerlerine hafif basınç uygulanınca tabana doğru gömülmektedirler, buna "düğme-delik betirtisi" denilmektedir. 3,6 Olgumuzda bazı nörofibromlarda bu bulguya rastlanmıştır. Pleksiform nörofibromlar ise sıklıkla yüz bölgesinde bulunur.…”

Section: Olgu Sunumuunclassified

Neurofibromatosis Type 1 Case with Becker Nevus and Hamartoma

Kaymak¹,

Bassoy²

2015

Turkiye Klinikleri J Dermatol

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Spontaneous Massive Hemothorax in a Patient with Neurofibromatosis Type 1 with Successful Transarterial Embolization

Cited by 22 publications

References 11 publications

Aneurysmal rupture of the costo-cervical trunk in a patient with neurofibromatosis type 1: A case report

Aneurysmal rupture of the costo-cervical trunk in a patient with neurofibromatosis type 1: A case report

Interventionell-radiologische Behandlung von Interkostalarterienblutungen – eine retrospektive Analyse

Neurofibromatosis Type 1 Case with Becker Nevus and Hamartoma

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