1/19. rupture of aortic aneurysm with right-sided haemothorax.A 62-yr-old male with a history of high blood pressure was admitted for persistent dyspnoea and a right-sided pleural effusion, complicated by a recent episode of shock. There was no history of trauma and the patient denied any thoracic pain. A chest tube was inserted which released nonclotting bloody fluid. A thoracic computed tomographic scan of the chest revealed an aneurysm of the inferior third of the descending thoracic aorta. The patient underwent a successful prosthetic graft replacement. We emphasize that rupture of aortic aneurysms should be considered in the evaluation of spontaneous haemothorax even if it is right-sided and not associated with pain.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
2/19. Hepatocellular carcinoma complicated by hemothorax.Although hemoperitoneum is a well-known cause of death induced by rupture of hepatocellular carcinoma (HCC). hemothorax caused by rupture of HCC has not been adequately described. We report here a 64-year-old woman who died of bleeding from pleural wall metastasis of HCC. She presented with liver failure and sudden-onset hypotension, and on the same day, she died of hypovolemic shock associated with liver failure. autopsy revealed HCC metastatic to the lungs and right pleura and 21 of bloody pleural effusion in the right side. The cut surface of the metastatic nodule in the right pleura was filled with coagulated blood and necrotic tissue. We concluded that the pleural metastasis had ruptured and caused the right hemothorax. We discuss reported cases of HCC complicated by hemothorax.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
3/19. Severe complications of mediastinal pancreatic pseudocyst: report of esophagobronchial fistula and hemothorax.We report two patients with alcoholic pancreatic pseudocyst which communicated to the mediastinal space through the aortic hiatus, in one patient resulting in hypotensive shock due to hemothorax, and in the other, resulting in esophagobronchial fistula via the mediastinal cyst. The first patient was successfully treated by radical resection of the pancreatic body and tail, and the spleen, with an ultrasonic scalpel, although inflammatory changes caused by pancreatitis were so prominent that the splenic vein was occluded. The second patient could not be treated surgically, because the superior mesenteric vein had been occluded by chronic pancreatitis; he died of respiratory failure and sepsis due to aspiration pneumonia, despite receiving medical treatment.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
4/19. Ruptured idiopathic pulmonary artery aneurysm: unusual case of hemothorax treated by selective embolization.Aneurysm of the peripheral pulmonary arteries is rare. rupture of pulmonary artery aneurysms manifesting as recurrent hemoptysis with exsanguination is well recognized. We report the case of a young woman who presented with massive hemothorax and shock at the sixth month of pregnancy due to a ruptured lingular artery aneurysm. She was treated with selective coil embolization of the lingular artery to achieve hemostasis. Subsequently, clot evacuation from the pleural space was done. This case is reported for its unsuspected presentation, rarity and to highlight the use of catheter coil embolization to achieve control of bleeding and exclusion of the aneurysm from the pulmonary circulation.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
5/19. Fatal inhalational anthrax with unknown source of exposure in a 61-year-old woman in new york city.A 61-year-old woman who was a new york city hospital employee developed fatal inhalational anthrax, but with an unknown source of anthrax exposure. The patient presented with shortness of breath, malaise, and cough that had developed 3 days prior to admission. Within hours of presentation, she developed respiratory failure and septic shock and required mechanical ventilation and vasopressor therapy. Spiral contrast-enhanced computed tomography of the chest demonstrated large bilateral pleural effusions and hemorrhagic mediastinitis. Blood cultures, as well as dna amplification by polymerase chain reaction of the blood, bronchial washings, and pleural fluid specimens, were positive for bacillus anthracis. The clinical course was complicated by liver failure, renal failure, severe metabolic acidosis, disseminated intravascular coagulopathy, and cardiac tamponade, and the patient died on the fourth hospital day. The cause of death was inhalational anthrax. Despite epidemiologic investigation, including environmental samples from the patient's residence and workplace, no mechanism for anthrax exposure has been identified.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
6/19. Unusual presentation of rib exostosis.We report two cases of unusual presentation of rib exostosis. The first patient presented acutely with hemorrhagic shock due to massive hemothorax, and the second patient presented with repetitive chest infection complicated by empyema. In both patients, preoperative computed tomographic (CT) scan of the chest revealed rib exostoses, necessitating thoracotomy and rib resection.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
7/19. Bilateral and unilateral spontaneous massive hemothorax as a presenting manifestation of rare tumors.Spontaneous true hemothorax is quite a rare manifestation of a presenting disease. This is a report of two patients, one with bilateral spontaneous massive hemothorax as a presenting manifestation of angiosarcoma involving the lungs and pleura, and the other with unilateral spontaneous hemothorax and hemorrhagic shock as a presenting manifestation of 'cystic' chondroblastoma. Differential diagnosis of spontaneous true hemothorax and its evaluation and management are discussed.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
8/19. An adult case of Bochdalek hernia complicated with hemothorax.A 53-year-old female with mild shock due to vomiting and abdominal pain visited the emergency room of our hospital. Chest X-ray on admission showed a large amount of left pleural effusion. Thoracentesis revealed hemorrhagic pleural effusion. An upper gastrointestinal series showed interruption of the upper gastric body, but the anal side was not visualized. Contrast X-ray examination of the thoracic cavity via the drainage tube demonstrated intrathoracic herniation through the diaphragm. These findings suggested gastric impaction in the foramen of Bochdalek, and thoracotomy was immediately performed. A black-colored stomach and greater omentum, suggesting necrotic changes, were observed in the thoracic cavity, and there was bleeding from the greater omentum. Resection of the necrotic organs and closure of the hernial orifice were followed by good recovery.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
9/19. Autologous salvaged blood transfusion in spontaneous hemopneumothorax.Spontaneous hemopneumothorax (SHP) is a rare clinical entity, and an emergent operation due to continuous bleeding or hypovolemic shock is at times necessary. Although allogeneic blood transfusions are urgently required for significant blood loss, autologous blood transfusions can also be considered in patients with SHP. We herein report two cases of successful autologous blood transfusions using blood in the pleural space, decreasing or obviating the need for allogeneic blood transfusion.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
10/19. Intrapleural rupture of the azygos vein.Intrapleural rupture of the azygos vein associated with hypovolemic shock resulting from blunt chest trauma is reported. Management demanded an emergency department right thoracotomy with venous ligation. aortography to rule out associated arterial injury was performed. The previously published 7 cases of azygos vein rupture are reviewed as are possible etiologic mechanisms responsible for this rare injury. The history and clinical signs compatible with this injury are emphasized.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
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