IMAGES IN EMERGENCY MEDICINE
Atypical extravasation of contrast medium in massive extrapleural haematoma due to cardiac massage without rib fracture
1 Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Japan
2 Department of Radiology, Tokai University School of Medicine, Japan
3 Department of Cardiology, Tokai University School of Medicine, Japan
Correspondence to:
Correspondence to Dr S Morita, Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, 143 Shimokasuya Isehara City, Kanagawa 259-1193, Japan; morita@is.icc.u-tokai.ac.jp
Accepted 13 June 2008
| The first 150 words of the full text of this article appear below. |
A 72-year-old man was admitted to the emergency department with a diagnosis of inferior myocardial infarction. During intervention with heparin, ventricular fibrillation suddenly occurred. Twelve minutes after resuscitation he was successfully defibrillated with cardiac massage and defibrillation therapy. His respiratory condition progressively worsened and the chest radiograph revealed a decrease in the filtration rate of the right lung. A CT scan of the thorax showed a massive right extrapleural haematoma without rib fracture, with an atypical extravasation of contrast media (fig 1A). Emergency angiography was performed which revealed extravasation of contrast media from the intercostal artery (fig 1B). Haemostasis was successfully achieved by embolisation; however, the patient died due to low output syndrome on the third hospital day.
Figure 1 (A) Contrast-enhanced CT scan of the thorax showing atypical extravasation of contrast media in a massive right extrapleural haematoma. (B) Angiography of the intercostal artery showing active extravasations | |||||||||
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