Spontaneous intercostal arterial rupture restrained by conservative management

Area of Science:

• Vascular Surgery
• Interventional Radiology

Background:

• Spontaneous intercostal arterial rupture without trauma or illness is exceptionally rare.
• Idiopathic arterial rupture presents a diagnostic and management challenge.

Observation:

• A 58-year-old male presented with 3 days of intermittent back pain.
• Imaging revealed a blood effusion around the descending aorta and a hematoma from the right 10th intercostal artery.

Findings:

• The patient experienced an idiopathic and spontaneous rupture of the right 10th intercostal artery.
• Conservative management, including blood pressure control and tranexamic acid, led to an uneventful recovery.

Implications:

• This case suggests conservative management can be effective for select cases of spontaneous intercostal arterial rupture.
• Further research into the etiology and optimal management of idiopathic arterial injuries is warranted.