[Massive iatrogenic haemothorax treated by lidocaïne-adrenaline intercostal injection].
BACKGROUND
Massive haemothorax is a relatively rare complication of thoracocentesis or the placement of tube thoracostomy. It is principally caused by intercostal vessel injury. The therapeutic approach consists in pleural drainage and sometimes thoracotomy for haemostasis.


METHODS
We describe a frail 72 year old patient, who developed a massive haemothorax occurring after a tube thoracostomy placing, persisting despite second pleural drainage, and complicated by deep haemodynamic shock. He was considered to have a very high risk of mortality if surgery was undertaken. Haemorrhage was totally stopped after intercostal instillation of lidocaïne-adrenaline.


CONCLUSIONS
This case report suggests a role for pleural vasoconstrictor injection as initial treatment in case of persistent pleural haemorrhage caused by intercostal vessel injury.
Bazarbachi
T
T
Service de Pneumologie et de réanimation médicale, Hôtel-Dieu de France, Beyrouth, Liban. tbazarbachi@hotmail.com
Ghantous
W
W
Daher
M
M
Smayra
T
T
Riachy
M
M
Chelala
D
D
Tabet
G
G
D000368:Aged; D015505:Chest Tubes; D004837:Epinephrine / Q000008:administration & dosage*; D006491:Hemothorax / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D007049:Iatrogenic Disease; D007273:Injections, Intramuscular; D007366:Intercostal Muscles / Q000187:drug effects; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D012151:Resuscitation / Q000379:methods; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine