Spontaneous rupture of intercostal artery after severe cough

Jang, Jee Yong; Lim, Yong Su; Woo, Jong Kyu; Jang, Jae Ho

doi:10.1016/j.ajem.2014.06.033

Cited by 28 publications

(36 citation statements)

References 14 publications

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“…There are only a few reported cases of spontaneous ICA bleeding in the literature [14][15][16][17][18][19][20][21][22]. To our knowledge, this is the first case description of ICA bleeding associated with LLIF surgery.…”

Section: Discussionmentioning

confidence: 96%

“…To our knowledge, this is the first case description of ICA bleeding associated with LLIF surgery. Besides trauma, which is the most common reason for intercostal bleeding, predisposing factors include Neurofibromatosis Type 1, systemic lupus erythematosus (SLE), uncontrolled hypertension, anticoagulation and bleeding disorders [15,16,19,20,22,23]. Neurofibromatosis Type 1 is associated with arterial stenosis due to intimal or medial dysplasia and also arteriovenous malformations and aneurysms, which may lead to spontaneous vessel rupture in rare cases.…”

Section: Discussionmentioning

confidence: 99%

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Intercostal artery hemorrhage with hemothorax following combined lateral and posterior lumbar interbody fusion: a case report

Rentenberger

Shue

Soffin

et al. 2019

Spinal Cord Ser Cases

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Introduction Lateral lumbar interbody fusion (LLIF) is a safe treatment for degenerative spine conditions. However, risk of complications such as vascular injuries remains. We report a unique case of an intercostal artery (ICA) hemorrhage with hemothorax following LLIF. Case presentation One hour after a right-sided LLIF L3-4 with posterior decompression L2-4 and L3-5 instrumentation, the patient became hypotensive, anemic and required vasopressor support. Evaluation revealed a right-sided hemothorax, which was caused by a bleeding intercostal artery, laterally at the 10th intercostal space. A lateral thoracotomy was performed to stop the bleeding. After vessel ligation and placement of two chest tubes, the patients' hemodynamics improved. The patient remained intubated overnight and was extubated on the first postoperative day. Discussion Vascular injury is a rare complication of LLIF procedures. Most vascular injuries are segmental vessel lacerations, which resolve postoperatively. This is the first case description of ICA bleeding associated with LLIF surgery. Spontaneous ICA bleeding exists, but surgeons should be aware of careful handling in patients with vascular risk factors, especially with regard to patient positioning required in certain spinal surgical approaches. Timely vascular injury identification is critical for hemostasis and clinical management.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Intercostal artery hemorrhage with hemothorax following combined lateral and posterior lumbar interbody fusion: a case report

Rentenberger

Shue

Soffin

et al. 2019

Spinal Cord Ser Cases

View full text Add to dashboard Cite

show abstract

“…Four of these patients were hemodynamically unstable on presentation, and one died . Probable underlying etiologies suggested were violent coughing, uncontrolled hypertension, sexual intercourse, receiving anticoagulation therapy of warfarin following heparin, and serious comorbidities with hemorrhagic tendency such as systemic lupus erythematosus with antiphospholipid syndrome and dengue hemorrhagic fever…”

Section: Discussionmentioning

confidence: 99%

Spontaneous intercostal artery bleeding in a hemodialysis patient

Durey

Kim

2017

Hemodialysis International

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Spontaneous rupture of an intercostal artery (ICA) is a rare but could be a life-threatening emergency requiring prompt diagnosis and intervention for optimal outcome. We report a patient presented with swelling in his right-side back which started immediately after scheduled hemodialysis and continued to increase in size. Contrast computed tomography scan revealed soft tissue attenuated lesion with internal enhancing dots which suggested expanding hematoma with active bleeding. Arteriography detected focal contrast extravasation from seventh ICA, and transcatheter arterial embolization was successfully done. To the best of our knowledge, this is the first report describing spontaneous bleeding of ICA in a hemodialysis patient.

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“…Intercostal artery (ICA) injury is a rare but feared complication to common elective and emergency thoracic procedures such as thoracentesis, pleural biopsy, thoracoscopy or chest drain insertion [ 1 ]. It can also occur in penetrating or blunt thoracic trauma, or it may occur spontaneously [ 2 , 3 ]. As the tortuosity of intercostal arteries and traversing collaterals increase with age, older people are at higher risk [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Management of a life-threatening intercostal artery bleeding, difficult to visualize in open surgery: a case report

Laugsand

Xanthoulis

2020

Journal of Surgical Case Reports

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Life-threatening bleeding from an intercostal artery is a rare and challenging event. A 74-year-old patient with a right-sided pleural effusion was treated by a pigtail pleural drain. He developed a large haemothorax, initially addressed by a large bore chest tube. As he became haemodynamically unstable, he required an emergency anterolateral right thoracotomy. It was difficult to visualize and reach the bleeding vessel during open surgery. A 30° laparoscopy camera was introduced and the bleeding site was identified. An incision was made directly over the bleeding site and the two ends of the lacerated intercostal artery were ligated by two externally placed figure-of-eight sutures. The patient survived and recovered fully. As most general surgeons, even at smaller hospitals, are familiar with laparoscopy, the technique described here may be useful for other surgeons to employ if a life-threatening intercostal artery injury occurs.

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Spontaneous rupture of intercostal artery after severe cough

Cited by 28 publications

References 14 publications

Intercostal artery hemorrhage with hemothorax following combined lateral and posterior lumbar interbody fusion: a case report

Intercostal artery hemorrhage with hemothorax following combined lateral and posterior lumbar interbody fusion: a case report

Spontaneous intercostal artery bleeding in a hemodialysis patient

Management of a life-threatening intercostal artery bleeding, difficult to visualize in open surgery: a case report

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