Multiple‑site bleeding at pleural adhesions and massive hemothorax following percutaneous coronary intervention with stent implantation: A case report

Abstract

An elderly male patient with coronary heart disease underwent coronary angiography, which revealed bilateral severe coronary artery stenosis. Four stents were implanted, and at 5 h post-surgery, typical hemorrhagic shock appeared. Echocardiography verified heavy bleeding in the right thoracic cavity. Emergency angiography excluded injury or perforation of the coronary artery, aorta, right subclavian artery and brachiocephalic artery. Considering the patient's history of chronic obstructive pulmonary disease and severe cough during the operation, it was suspected that hemothorax was induced by a blood vessel rupture in the pleura. Video-assisted thoracic examination confirmed the tearing of pleural adhesion bands and bleeding at three sites in the pulmonary pleura and parietal pleura. According to the reported case, bleeding as a result of the laceration of pleural adhesions is an important cause of hemothorax that should be considered after exclusion of other common causes of pleural hemorrhage.

Hemorrhagic shock caused by preoperative computed tomography-guided microcoil localization of lung nodules: a case report

“…2D) and subsequent thoracoscopic surgery identified the aberrant vessel. Similar cases have been reported in spontaneous pneumothorax related pathologies [18,19]. As in our case, the most frequent bleeding location is the superior thoracic aperture [18], possibly due to its higher incidence of pleural adhesions.…”

Spontaneous Tension Hemothorax in a Patient with Asbestosis

“…This entity has been reported previously only in a patient with chronic obstructive pulmonary disease. 2 The hemodynamic instability of our patient was attributed to obstructive shock due to tension hemothorax. Tension hemothorax is typically caused by major chest trauma or ruptured thoracic aortic aneurysm, and it rarely…”

“…This entity has been reported previously only in a patient with chronic obstructive pulmonary disease. 2 …”

Delayed massive haemopneumothorax with shock after ‘Zumba’

“…This case is unique due to the delayed development of haemopneumothorax after non‐contact sport without evidence of blunt thoracic trauma. Vascularized adhesions can be torn by tractive forces such as twisting which may be evident in Zumba resulting in haemorrhage 6 . Negative pressure within the pleural cavity may lead to significant haemorrhage and in this case our patient progressed to a peri‐arrest state of shock in a short time frame.…”