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Case Reports
. 2023 Dec 23;16(12):e254265.
doi: 10.1136/bcr-2022-254265.

Massive haemothorax and haemorrhagic shock due to cervical vascular injury caused by a seat belt

Tomoya Nishino  1 , Asuka Tsuchiya  2   3 , Seiji Morita  1 , Yoshihide Nakagawa  1
Affiliations
Case Reports

Massive haemothorax and haemorrhagic shock due to cervical vascular injury caused by a seat belt

Tomoya Nishino et al. BMJ Case Rep. .

Abstract

A woman in her 50s was transported to our hospital after experiencing a road traffic crash that led to a massive haemothorax and haemorrhagic shock due to a cervical vascular injury caused by the seat belt. Contrast-enhanced CT of the chest showed extravascular leakage of the contrast medium from the vicinity of the right subclavicular area and fluid accumulation in the thoracic cavity. The patient was intubated, and a thoracic drainage catheter was placed. She underwent angiography and embolisation of the right costocervical trunk, right thyrocervical trunk and right suprascapular artery using a gelatine sponge and 25% N-butylcyanoacrylate-Lipiodol. She was extubated on the second day after stabilisation of the respiratory and circulatory status. In cases where the bleeding vessel is known and an emergency thoracotomy can serve as a backup, embolisation by interventional radiology should be considered the initial treatment approach.

Keywords: Adult intensive care; Interventional radiology; Medical education; Resuscitation; Trauma.

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Conflict of interest statement

Competing interests: None declared.

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