Delayed Hemothoraxand Pericardial Tamponade Secondary to Stab Wounds to the Internal Mammary Artery

摘要

Massive delayed hemothorax as a consequence of stab wounds to the internal mammary artery has been reported in only one study in the western literature.A review of patients who sustained injuries to the parasternal region with internal mammary artery injuries is discussed.Three patients with injuries to this structure that developed delayed a hemothorax were identified. One of the patients had a combination of a delayed hemothorax and pericardia! tamponade. All three patients were treated with emergency antero-lateral thoracotomies.Internal mammary artery injuries had a high riskforthe development of a delayed hemothorax. Patients with parasternal injuries should be admitted to a telemetry unit, where thoracostomy tube outputs and vital signs can be monitored continu-ously.The addition of sonography to identify blood in the pericardial sac and a lateral chest X-ray view to rule out an extrapleural hematoma are useful and should be considered in the management of these patients.