Intercostal arterial injury
Patient presenting after altercation with stab wound to the chest.
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There is a tear of the left 10th intercostal artery from a stab wound to the left lower posterolateral chest wall. There are small collections of extravasated contrast in the adjacent extrapleural space and there is active extravasation of contrast into the left pleural space where there is a large hemothorax.
There is laceration of the external oblique and latissimus dorsi muscles. There is indentation of the diaphragm by the small extrapleural collections of extravasated contrast.
4 case question available
CT angiography can be used to detect the presence of vascular injury, including active internal bleeding. Furthermore, CT can be used to detect the presence of metallic foreign bodies, the path of a stab wound. Blood in the pleural space typically has an attenuation higher than that of a pleural effusion (approximately 35-70 HU).
Supervised by: Dr. Geneviève Belley
Case courtesy of Dr. Joseph Cassulo
- Dreizin D, Dreizin MF, Dreizin. Multidetector CT for Penetrating Torso Trauma: State of the Art. (2015) Radiology. doi:10.1148/radiol.2015142282 - Pubmed
- R. T. Villavicencio, J. A. Aucar, M. J. Wall, Jr.. Analysis of thoracoscopy in trauma. (1999) Surgical Endoscopy. 13 (1): 3. doi:10.1007/s004649900886 - Pubmed