Hemothorax by intercostal varicose veins in alcoholic liver cirrhosis.

摘要

A 58-year-old man with alcoholic liver cirrhosis and signs related to portal hypertension (such as esophageal varices) was admitted to the GB Morgagni hospital (For-li, Italy) because of acute-onset breathlessness and weakness. His blood pressure was 90/55 and laboratory values showed anemia (hemoglobin 7.9 g/dl, hematocrit 23.5%). Packed red cells (2 units) were immediately administered intravenously, after which the blood pressure rose to 110/65. Meanwhile, a posterioanterior chest radiograph demonstrated a massive right pleural effusion. A thora-centesis was performed and approximately 700 ml of hemorrhagic pleural effusion was evacuated. The day after the thoracentesis the patient underwent medical tho-racoscopy for evacuation of the pleural effusion and for diagnosis. After aspiration of 2,200 ml of hemorrhagic pleural fluid (with hematocrit of 8%), the exploration of the thoracic cavity revealed at the 9th and 10th posterior intercostal space the presence of intercostal varicose veins with recent signs of bleeding (fig. la, b).