Traumatic intercostal artery pseudoaneurysm following a bicycle accident

Area of Science:

• Forensic Pathology
• Trauma Surgery
• Vascular Surgery

Background:

• Blunt-force trauma can lead to delayed vascular complications.
• Intercostal artery pseudoaneurysms are rare but potentially fatal injuries.
• A significant delay between trauma and pseudoaneurysm rupture is infrequently documented.

Purpose of the Study:

• To present a unique case of fatal intercostal artery pseudoaneurysm rupture.
• To highlight the long interval between blunt trauma and this rare fatality.
• To discuss the forensic pathology and clinical implications of delayed vascular injury.

Main Methods:

• Autopsy examination of a 49-year-old female with uncertain cause of death.
• Gross examination revealed healed rib fractures and hemothorax.
• Histological analysis identified a ruptured left tenth intercostal artery pseudoaneurysm.

Main Results:

• The patient had a history of a bicycle accident 4 years prior, causing left-sided blunt trauma.
• Autopsy findings included healed left lower rib fractures and significant left hemothorax.
• Histology confirmed a ruptured intercostal artery pseudoaneurysm with evidence of recent hemorrhage.

Conclusions:

• The patient died from hemorrhagic shock due to a ruptured intercostal artery pseudoaneurysm.
• The pseudoaneurysm likely formed as a delayed consequence of blunt trauma sustained 4 years earlier.
• This case underscores the importance of considering long-term vascular complications after seemingly minor trauma.