Eur J Cardiothorac Surg 2005;28:165
© 2005 Elsevier Science NL
Images in cardio-thoracic surgery |
Post-traumatic intrapulmonary rupture of the pulmonary artery
Giulio Melloni
a
,
*
,
Monica Casiraghi
a
,
Roberto Nicoletti
b
,
Piero Zannini
a
a Department of Thoracic Surgery, Scientific Institute H. San Raffaele, Milan, Italy
b Department of Radiology, Scientific Institute H. San Raffaele, Milan, Italy
Received 8 November 2004;
received in revised form 30 March 2005;
accepted 31 March 2005.
* Corresponding author. Address: U.O. Chirurgia Toracica, Ospedale San Raffaele, 20132 Milano, Italy. Tel.: +39 02 2643 7139; fax: +39 02 2643 7147. (Email: giulio.melloni{at}hsr.it).
Key Words: Chest trauma • Pulmonary vascular injury • Pulmonary artery
A 64-year-old woman was admitted for chest trauma with unstable hemodynamics. CT scan revealed an extravasation of the contrast medium into a large intrapulmonary blood collection. Because of the persistence of hemodynamic instability, major pulmonary vascular injury was suspected and an emergency thoracotomy was performed. The presumed diagnosis of rupture of the basal arterial trunk was confirmed at operation and a left lower lobectomy was successfully performed (Fig. 1
).
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Fig. 1. (a and b) Contrast enhanced CT scan showing a rupture of the left basal arterial trunk as the source of bleeding with secondary formation of a large (4x9cm) intrapulmonary blood collection. Arrow SA: superior segmental artery of the left lower lobe. Arrow BA: basal arterial trunk. Arrow CM: extravasation of the contrast medium. Arrow BC: intrapulmonary blood collection. Arrow BT: branches of the basal arterial trunk.
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