Congenital Aberrant Vessel as a Source of Massive Hemothorax in Blunt Trauma

Introduction

An aberrant vessel arising from the pleural cupola has been documented to be a source of life-threatening bleeding in spontaneous hemopneumothorax [1]. Aberrant vessels are thought to be congenital in origin when they characteristically lack pleural adhesions or inflammatory changes on the pleural surface around them. Previously, these vessels have never been considered as important bleeding sources in blunt trauma. We report a case of hemothorax in which a congenital aberrant vessel was ruptured by a relatively low energy deceleration injury, resulting in massive hemothorax without any other vessel injury, rib fracture or bleeding source.

References

• 1 Kurimoto Y, Hatamoto K, Hase M. et al . Aberrant artery as a source of bleeding in spontaneous hemopneumothorax.  Am J Emerg Med. 2001;  19 326-327
• 2 Lin T S, Wang N P, Huang L C. Pitfalls and complication avoidance associated with transthoracic endoscopic sympathectomy for primary hyperhidrosis (analysis of 2200 cases).  Int J Surg Investig. 2001;  2 377-385
• 3 Muraguchi T, Tsukioka K, Hirata S. et al . Spontaneous hemopneumothorax with aberrant vessels found to be the source of bleeding: report of two cases.  Surg Today. 1993;  23 1119-1123
• 4 Pretre R, Chilcott M. Blunt trauma to the heart and great vessels.  N Engl J Med. 1997;  336 626-632
• 5 Tatebe S, Kanazawa H, Yamazaki Y. et al . Spontaneous hemopneumothorax.  Ann Thorac Surg. 1996;  62 1011-1015