Intrapleural rupture of the azygos vein

Intrapleural rupture of the azygos vein associated with hypovolemic shock resulting from blunt chest trauma is reported. Management demanded an emergency department right thoracotomy with venous ligation. Aortography to rule out associated arterial injury was performed. The previously published 7 cases of azygos vein rupture are reviewed as are possible etiologic mechanisms responsible for this rare injury. The history and clinical signs compatible with this injury are emphasized.