Intercostal arterial injury

Case contributed by Marius I. Diaconescu

Presentation

Patient presenting after altercation with stab wound to the chest.

Patient Data

Age: 30 years
Gender: Male
CT

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.

Case Discussion

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

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Case information

rID: 77465
Published: 1st Jun 2020
Last edited: 7th Jul 2020
System: Trauma, Chest
Inclusion in quiz mode: Included
Institution: McGill University

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