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Images in Cardiothoracic Medicine and Surgery

Delayed dorsal scapular artery pseudoaneurysm rupture after blunt chest injury

Asian Cardiovascular & Thoracic Annals 0(0) 1–2 ß The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492314558520 aan.sagepub.com

Luis Gorospe1, Ana Palomera-Rico1 and Gemma Marı´a Mun˜oz-Molina2

Figure 2. Coronal computed tomography showing a large hematoma involving the right rhomboid muscles and extending caudally and laterally to the anterior serratus and latissimus dorsi muscles (asterisks).

Figure 1. (A) Axial and (B) volume-rendered thoracic computed tomography showing a large pseudoaneurysm in the right posterior chest wall (arrows).

An otherwise healthy 83-year-old woman who had fallen 2 months earlier and suffered multiple nondisplaced right rib fractures, presented with sudden onset of back pain. Physical examination revealed a tender mass in the right posterior chest wall. She was hemodynamically stable but her hemoglobin levels showed a 4-hour decrease from 12.5 to 9.5 gdL 1. Thoracic computed tomography revealed a large pseudoaneurysm in the right posterior chest wall, located between the right paravertebral muscles, the posterior aspect of the third rib, and the medial border of the right scapula (Figure 1). A large hematoma was seen involving the right rhomboid muscles and extending caudally and

laterally to the ipsilateral anterior serratus and latissimus dorsi muscles (Figure 2). A decision was made to embolize this pseudoaneurysm. Angiography confirmed a large ruptured pseudoaneurysm arising from a branch of the dorsal scapular artery, which was successfully embolized using ethylene-vinyl alcohol copolymer (Figure 3). The patient’s pain and her hematoma improved soon after selective embolization of the ruptured pseudoaneurysm. To the best of our knowledge, there are no previous reports describing embolization of a ruptured pseudoaneurysm of the dorsal scapular artery following blunt chest trauma.

1 Department of Radiology, Ramo´n y Cajal University Hospital, Madrid, Spain 2 Department of Thoracic Surgery, Ramo´n y Cajal University Hospital, Madrid, Spain

Corresponding author: Luis Gorospe, MD, Department of Radiology, Ramo´n y Cajal University Hospital, Ctra. de Colmenar Viejo Km 9.100, Madrid 28034, Spain. Email: [email protected]

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Asian Cardiovascular & Thoracic Annals 0(0)

Figure 3. (A) Angiography confirmed a large ruptured pseudoaneurysm arising from a branch of the dorsal scapular artery (arrows). (B) It was successfully embolized using ethylene-vinyl alcohol copolymer (asterisks).

Funding

Conflict of interest statement

This research received no specific grant from any funding agency in the public, commerical, or not-for-profit sectors.

None declared.

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Delayed dorsal scapular artery pseudoaneurysm rupture after blunt chest injury.

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