Abstract
We report the case of a 66-year-old man who died of fatal delayed hemothorax after blunt trauma to the chest. When the deceased was transferred to the hospital, his vital signs were stable; hence, medical attention was focused only on the fracture on right ankle. Three days after the orthopedic surgery, he became unsettled with symptoms similar to delirium and exhibited unstable vital signs; he then suddenly died. On autopsy, a beveled fracture was identified on the posterior aspect of the left second rib with hemothorax. It was because of a rupture in the intercostal artery at the fracture site that a simple fracture in a rib, following a blunt chest trauma can be a potentially life-threatening condition. We suggest that a meticulous examination should be performed at the rib fracture sites when a blunt trauma to the chest is suspected even when there are no internal organ injuries identified except hemothorax.
REFERENCES
1.Chen CL., Cheng YL. Delayed massive hemothorax complicating simple rib fracture associated with diaphragmatic injury. Am J Emerg Med. 2014. 32:818. .e3-4.
2.Sharma OP., Hagler S., Oswanski MF. Prevalence of delayed hemothorax in blunt thoracic trauma. Am Surg. 2005. 71:481–6.
3.Kim WS., Kim JS. Delayed diaphragmatic injury with massive hemothorax due to lower rib fracture. J Trauma Inj. 2015. 28:79–82.
4.Masuda R., Ikoma Y., Oiwa K, et al. Delayed hemothorax superimposed on extrapleural hematoma after blunt chest injury: a case report. Tokai J Exp Clin Med. 2013. 38:97–102.
5.Ahn HJ., Lee JW., Kim KD, et al. Phrenic arterial injury presenting as delayed hemothorax complicating simple rib fracture. J Korean Med Sci. 2016. 31:641–3.
6.Misthos P., Kakaris S., Sepsas E, et al. A prospective analysis of occult pneumothorax, delayed pneumothorax and delayed hemothorax after minor blunt thoracic trauma. Eur J Cardiothorac Surg. 2004. 25:859–64.