We report a patient with type B aortic dissection which ruptured into the right
hemothorax to call attention to this infrequent presentation and to accentuate the value of computed tomography angiography (CTA) with multiplanar reformatting in localizing the dissection and demonstrating the rupture site.
The initial chest radiograph (Figure 1) shows right sided moderate to massive
hemothorax (black arrow), and mild surgical emphysema (blue arrow).
Various surgical sympathectomy procedures were utilized in subsequent decades, but these procedures were often associated with significant complications, including pneumothorax,
hemothorax, disabling hyperhidrosis, and neuropathic pain.
Postoperative complications were mainly NCs (stroke or transient ischemic attack, paraplegia, and paraparesis), respiratory complications (
hemothorax and pneumothorax), infectious complications (surgical site infections, blood stream infections, meningitis, and respiratory infections), and renal dysfunction.
[15] The most important advantages of biceps brachii muscle flap from these mentioned flaps are the shorter duration of surgery due to the local nature of biceps brachii flap and absence of hematoma and seroma due to excessive dissections, and lack of thoracic complications such as pneumothorax and
hemothorax. Furthermore, use of biceps brachii flaps does not have the possible flap complications due to microsurgery methods.
Although there might be an asymptomatic period, if left untreated, the sharp nature of needles enables them to rapidly migrate through the tissues, leading to serious complications, including cardiac tamponade,
hemothorax and pneumothorax; thus, delayed diagnosis is associated with poor outcome (1).
It is mainly used to diagnose or rule out
hemothorax, pericardial effusion, fractures, diaphragmatic rupture, and pneumothorax, as well as a guide to obtaining vascular access.
A variety of rare complications such as perforation of the left brachiocephalic vein and massive
hemothorax, chylothorax, internal mammary artery malposition of catheter, and inadvertent placement of a CVC in the left pericardiophrenic vein have been reported previously [5-8].
Pacemaker insertion is a safe procedure with a 3% incidence of major complications, including perforation of heart chambers with or without tamponade, pneumothorax,
hemothorax, and air embolism [4].
Noncontrast CT was performed after emergency PCI, which revealed right
hemothorax without any chest wall fractures.
Although NG tube application is generally considered safe, it can result in complications such as pneumothorax, pneumomediastinum, subcutaneous emphysema, pneumonia, pulmonary hemorrhage, empyema,
hemothorax, mediastinitis, bronchopleural fistula, perforation [2].
A massive right
hemothorax occurred: a middle lobe laceration was noted, and lobectomy was performed.