Spontaneous rupture of an intercostal artery

Spontaneous rupture of an intercostal artery is exceptionally rare. It can be complicated by haemothorax, haematoma and/or retroperitoneal haemorrhage, which contributes to its morbidity and mortality. The authors report a case of a 76-year-old patient who was referred to the emergency department for pain associated with the appearance of a mass with progressive growth for 2 days in the right subscapular region. The patient had no previous history of trauma, ecchymosis or noticeable skin changes. History included the use of acetylsalicylic acid and a history of heart failure, as well as haemodialysis due to stage 5 chronic renal disease. CT scan showed an active haemorrhage from an artery in the fifth intercostal space. Embolisation was performed with microspheres and microcoils. No complications or recurrent bleeding was observed. Spontaneous rupture of an intercostal artery is rare, but it is an emergency requiring immediate diagnosis and intervention.