A case of a hemothorax due to rupture of an intercostal arterial aneurysm in a patient with neurofibromatosis type 1

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  • 神経線維腫症1型に合併した肋間動脈瘤破裂による血胸の1例

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Abstract

<p>A 45-year-old man was admitted to our hospital due to sudden left back pain. He had neurofibromatosis type 1 (NF1). Chest computed tomography (CT) showed left pleural effusion. A chest drainage tube was inserted, and bloody effusion was obtained. Because the bleeding source could not be identified by contrast-enhanced CT, we performed thoracoscopic surgery to identify the source, which was near the 11th costotransverse joint. Bleeding was stopped by direct pressure with a tissue-sealing sheet and fibrin glue.</p><p>Subsequent arteriography revealed aneurysms in the 11th intercostal artery, and transcatheter arterial embolization (TAE) was performed. His postoperative course was uneventful.</p><p>It is important to keep in mind that rupture of an intercostal arterial aneurysm might cause hemothorax in patients with NF1. Surgical interventions such as ligation, cauterization, and coagulation might be high-risk procedures because vascular walls in NF1 patients are fragile. Thoracoscopic surgery of temporal hemostasis and subsequent TAE could be a treatment of choice for such cases.</p>

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