Camarillo-Reyes LA, Marquez-Córdova RI, Surani S, Varon J. Hemothorax induced by severe cough: An unusual presentation.
SAGE Open Med Case Rep 2019;
7:2050313X19846043. [PMID:
31065358 PMCID:
PMC6487754 DOI:
10.1177/2050313x19846043]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 04/03/2019] [Indexed: 02/05/2023] Open
Abstract
Massive hemothorax resulting from cough-induced rib fracture is a condition in which blood accumulates in the chest, compromising the lungs and mediastinal structures. The most common cause of massive hemothorax is acute pro-traumatic injury. We present a case of a 47-year-old gentleman with morbid obesity and psoriasis, who was admitted to the emergency department due to shortness of breath that has been increased progressively after coughing for a period of 2 weeks. Chest radiograph demonstrated a large density in the left hemithorax, collapsing the left lung. Chest computerized tomography showed a left seventh rib fracture and massive pleural effusion. A closed chest tube thoracostomy was performed draining 3 L of hemorrhagic effusion, likely due to bleeding from the intercostal artery tear due to severe and prolonged cough. Cough-induced hemothorax due to spontaneous rib fractures are rare and clinicians should be well aware of this entity to prevent hemorrhagic shock and organ damage.
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