title: [Embolisation in spontaneous haemopneumothorax].
abstract: BACKGROUND
  Spontaneous haemopneumothorax is a rare disorder and is defined as spontaneous pneumothorax associated with the accumulation of more than 400 ml of blood in the pleural cavity.
  
  
  METHODS
  A 32-year-old male presented at the emergency department following sudden onset of right-sided stinging chest pain and difficulty in breathing. The chest X-ray showed right-sided hydropneumothorax. A tube thoracostomy was performed, which immediately drained 1500 ml of sanguinolent fluid. The first CT-scan showed no active bleeding. Several hours later the patient became haemodynamically unstable and an additional CT-angiogram was performed. This revealed an extravasation in the area of the second posterior intercostal artery, which was successfully embolised subsequently. This resulted in a haemodynamically stable patient, allowing elective video-assisted thoracic surgery.
  
  
  CONCLUSIONS
  Spontaneous haemopneumothorax is a life-threatening disorder. After initial drainage video-assisted thoracic surgery is to be preferred to conservative treatment or thoracotomy. However, it is necessary for the patient to be haemodynamically stable. In this case intervention radiology contributed to a minimally invasive approach. This therefore also merits consideration as a therapeutic option.
authors.affiliation: Medisch Centrum Haaglanden, Afd. Heelkunde, Den Haag, the Netherlands.
authors.forename: Erwin A
authors.initials: EA
authors.lastname: Gorter
authors.forename: Emile F L
authors.initials: EF
authors.lastname: Dubois
authors.forename: Onno R
authors.initials: OR
authors.lastname: Guicherit
authors.forename: Thijs A J
authors.initials: TA
authors.lastname: Urlings
authors.forename: J C Alexander
authors.initials: JC
authors.lastname: de Mol van Otterloo
mesh_terms: D004322:Drainage; D004621:Embolization, Therapeutic / Q000379:methods*; D006439:Hemodynamics; D006468:Hemopneumothorax / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult