[A case of intrapleural rupture of pulmonary arteriovenous malformation with shock]

We report a case of a 59-year-old male who suddenly developed massive right hemothorax and shock due to pulmonary arteriovenous malformation (AVM). He was admitted as an emergency case because of severe back pain, cyanosis and cold sweat. Although shock with massive right hemothorax was found, echocardiographic and X-ray computed tomographic examination showed no dilatation of the aorta, no intimal flap in the aorta and no pericardial effusion which suggested aneurysm. Pulmonary arteriography, performed subsequently, disclosed intrapleural rupture of the right pulmonary AVM. The patient recovered successfully from the state of shock. The pulmonary AVM was removed by segmentectomy of the right lung (S4). He was discharged following an uneventful postoperative course. Intrapleural rupture with shock is a very rare complication of pulmonary AVM. Pulmonary AVM should be considered as one possible cause in patients with massive hemothorax and shock.