title: Massive hemothorax due to inferior phrenic artery injury after blunt trauma.
abstract: Injury to the inferior phrenic artery after blunt trauma is an extremely rare event, and it may occur under unanticipated conditions. This case report describes an injury to the left inferior phrenic artery caused by blunt trauma, which was complicated by massive hemothorax, and treated with transcatheter arterial embolization (TAE). An 81 year-old female hit by a car while walking at the traffic intersection was transferred to the emergency department, computed tomography scanning revealed active extravasations of the contrast medium within the retrocrural space and from branches of the internal iliac artery. The patient underwent repeated angiography, and active extravasation of contrast medium was observed between the retrocrural space and the right pleural space originating from the left inferior phrenic artery. The injured left inferior phrenic artery was successfully embolized with N-butyl cyanoacrylate, resulting in stabilization of the patient's clinical condition. Inferior phrenic artery injury should be recognized as a rare phenomenon and causative factor for hemothorax. TAE represents a safe and effective treatment for this complication and obviates the need for a thoracotomy.
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma Japan ; Department of Diagnostic and Interventional Radiology, Gunma University Graduate School of Medicine, Maebashi, Gunma Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Aoki
authors.affiliation: Department of Diagnostic and Interventional Radiology, Gunma University Graduate School of Medicine, Maebashi, Gunma Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Shibuya
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Kaneko
authors.affiliation: Department of Diagnostic and Interventional Radiology, Gunma University Graduate School of Medicine, Maebashi, Gunma Japan.
authors.forename: Ayana
authors.initials: A
authors.lastname: Koizumi
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Murata
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hagiwara
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kanbe
authors.affiliation: Department of Diagnostic and Interventional Radiology, Gunma University Graduate School of Medicine, Maebashi, Gunma Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Koyama
authors.affiliation: Department of Diagnostic and Interventional Radiology, Gunma University Graduate School of Medicine, Maebashi, Gunma Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tsushima
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma Japan.
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Oshima
keywords: Blunt trauma; Inferior phrenic artery; N-butyl cyanoacrylate; Transcatheter arterial embolization