Spontaneous massive haemothorax caused by rupture of an intercostal vein

Spontaneous massive haemothorax is rare. We describe a healthy 44 year old woman who experience sudden onset chest pain while sleeping. Chest radiograph 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 emergency 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 was about 4000 ml. The patient recovered uneventfully, and her condition at follow up visits to the outpatient department was satisfactory.