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Medicina Legal de Costa Rica

On-line version ISSN 2215-5287Print version ISSN 1409-0015


BROWN, Joshua  and  LASSO DIAZ, Edgardo. Fatal hemothorax secondary to posterior intercostal artery injuries: case report. Med. leg. Costa Rica [online]. 2022, vol.39, n.1, pp.76-80. ISSN 2215-5287.

Intercostal artery injury is a poorly suspected differential diagnosis. It can be complicated by hemodynamic instability due to hemothorax or intrathoracic hematoma, which contributes to morbidity and mortality. We report the case of a 61-year-old patient with no pathological history known, who was presented to the emergency department for pain associated with respiratory distress following a blunt chest trauma due to a fall 8 days earlier. The Imaging studies revealed a right hemothorax, which required the placement of a pleural tube. An exploratory laparotomy was performed without evidence of bleeding or intra-abdominal collections, and he subsequently died. The necropsy examination revealed fractures of the ninth and tenth right posterior costal arch, associated with a posterior costal hematoma. The hemothorax that is secondary to an intercostal artery injury is rare, but it is an emergency that requires assertive diagnosis and timely intervention.

Keywords : Hemothorax; posterior intercostal arteries; hemorrhagic shock.

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