Emergency casebook
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Spontaneous haemothorax is a rare condition. Known causes of spontaneous haemothorax include tumour, anticoagulant therapy, arteriovenous malformation, pulmonary emboli, and tuberculosis. Tube thoracostomy drainage to evacuate unclotted blood and to monitor bleeding is the first consideration in cases of haemothorax. Surgical intervention is indicated if the haemodynamic status is unstable or if there is continuous blood loss. To our knowledge, only one case of spontaneous haemothorax without associated illness or injury has been reported. We describe a 44-year-old healthy female who suffered from sudden-onset chest pain while sleeping. The chest x-ray revealed massive right pleural effusion. Progressive dyspnoea, cold sweating, and tachycardia developed later. A tube thoracostomy was performed immediately and massive haemothorax was noted. An emergent thoracotomy was performed because of unstable vital signs. Disruption of the right third intercostal vein with continuous bleeding was observed and suture ligation of the vein was performed. The total blood loss
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