title: Spontaneous rupture of intercostal artery after severe cough.
abstract: Pleural or abdominal hematomas induced by spontaneous rupture of intercostal artery are very rare but can often cause fatal problems leading to hypovolemic shock. Spontaneous rupture of intercostal artery mostly occurs in association with neurofibromatosis type 1, coarctation of aorta, or trauma. In the absence of these conditions, there are very few cases. We report a 39-year-old man who complained of left flank pain after severe cough for a few days. His final diagnosis was hematoma of the left lateral abdominal wall induced by rupture of the left 11th intercostal artery. He was treated immediately by transarterial embolization. Without any serious problems during hospitalization, he was discharged. This case indicates that, in generally healthy individuals, even mild physical force such as cough can lead to rupture of the intercostal artery. Although it is very rare, injury to the intercostal artery should be considered when patients complain of unexplained chest pain, abdominal pain, or flank pain after strong cough or sneezing.
authors.affiliation: Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, South Korea.
authors.forename: Jee Yong
authors.initials: JY
authors.lastname: Jang
authors.affiliation: Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, South Korea. Electronic address: yongem@gmail.com.
authors.forename: Yong Su
authors.initials: YS
authors.lastname: Lim
authors.affiliation: Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, South Korea.
authors.forename: Jae Hyug
authors.initials: JH
authors.lastname: Woo
authors.affiliation: Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, South Korea.
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Jang
mesh_terms: D000328:Adult; D003371:Cough / Q000150:complications*; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic; D006491:Hemothorax / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D011859:Radiography; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D013895:Thoracic Arteries