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Hemothorax induced by severe cough: An unusual presentation
Luis Arturo Camarillo-Reyes1,2, Roberto Ivan Marquez-Córdova2,3, Salim Surani4
1Universidad Veracruzana, Xalapa, Mexico.
SAGE Open Medical Case Reports
|May 9, 2019
Summary
Massive hemothorax, a rare complication of severe coughing, occurred in a patient with a spontaneous rib fracture. Prompt intervention via chest tube thoracostomy successfully drained the accumulated blood.
Area of Science:
- Medical Case Study
- Thoracic Surgery
- Pulmonology
Background:
- Massive hemothorax typically results from traumatic injury.
- Spontaneous rib fractures leading to hemothorax are uncommon.
- This case highlights a rare etiology of hemothorax.
Observation:
- A 47-year-old male with morbid obesity and psoriasis presented with progressive shortness of breath.
- Symptoms worsened over two weeks, associated with severe coughing.
- Imaging revealed a left seventh rib fracture and significant left-sided hemothorax.
Findings:
- Chest X-ray showed a large density in the left hemithorax, causing lung collapse.
- CT scan confirmed the rib fracture and massive pleural effusion.
- A 3-liter drainage of hemorrhagic effusion was achieved via chest tube thoracostomy.
Implications:
- Bleeding likely originated from an intercostal artery tear due to forceful coughing.
- Clinicians must consider cough-induced hemothorax in patients with spontaneous rib fractures.
- Early recognition and management are crucial to prevent hemorrhagic shock and organ damage.
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