Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지
DOI QR코드

DOI QR Code

Massive Hemothorax Occurring with Intramural Hematoma of the Descending Aorta in the Early Postpartum Period

  • Yun, Jeong Hee (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jeon, Yeong Jeong (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Hong, Tae Hee (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Byun, Joung Hun (Department of Thoracic and Cardiovascular Surgery, Changwon Hospital, Gyeongsang National University School of Medicine) ;
  • Hwang, Sang Won (Department of Thoracic and Cardiovascular Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Park, Jae Hong (Department of Thoracic and Cardiovascular Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine)
  • Received : 2015.06.19
  • Accepted : 2015.09.23
  • Published : 2016.04.05
Download PDF
⟨ Previous Next ⟩

Abstract

Postpartum aortic intramural hematoma (IMH) is a rare but potentially lethal condition. We report a case of aortic IMH with massive hemothorax in a postpartum woman. The patient was a 31-year-old woman who had delivered twins by cesarean section. Two days after delivery, she complained of sudden-onset dyspnea. Chest computed tomography revealed a massive left hemothorax. Exploratory thoracotomy was performed, and we found a defect measuring approximately 6 mm in the adventitial layer of the thoracic aorta and an IMH. We repaired the defect primarily, and no more bleeding was observed. The patient was discharged on the 19th postoperative day without any complications.

Keywords

References

  1. Hwang YH, Song SW, Yi G. Delayed diagnosis of cardiac tamponade that was caused by intramural hematoma of the ascending aorta: a case report. Korean J Thorac Cardiovasc Surg 2010;43:194-8. https://doi.org/10.5090/kjtcs.2010.43.2.194
  2. Yuan SM. Postpartum aortic dissection. Taiwan J Obstet Gynecol 2013;52:318-22. https://doi.org/10.1016/j.tjog.2013.06.003
  3. Zeebregts CJ, Schepens MA, Hameeteman TM, Morshuis WJ, de la Riviere AB. Acute aortic dissection complicating pregnancy. Ann Thorac Surg 1997;64:1345-8. https://doi.org/10.1016/S0003-4975(97)00916-8
  4. Srettabunjong S. Spontaneous rupture of acute ascending aortic dissection in a young pregnant woman: a sudden unexpected death. Forensic Sci Int 2013;232:e5-8. https://doi.org/10.1016/j.forsciint.2013.08.005
  5. Magee LA, Pels A, Helewa M, Rey E, von Dadelszen P; Canadian Hypertensive Disorders of Pregnancy (HDP) Working Group. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Pregnancy Hypertens 2014;4:105-45. https://doi.org/10.1016/j.preghy.2014.01.003
  6. Braverman AC. Aortic dissection: prompt diagnosis and emergency treatment are critical. Cleve Clin J Med 2011;78:685-96. https://doi.org/10.3949/ccjm.78a.11053