Korean J Leg Med.  2017 May;41(2):56-59. 10.7580/kjlm.2017.41.2.56.

Fatal Delayed Hemothorax after Simple Rib Fracture

• Lee M
• Lim SB
• Kim HJ
• Park S
• Ha H

• KMID: 2379674
• DOI: http://doi.org/10.7580/kjlm.2017.41.2.56

Abstract

We report the case of a 66-year-old man who died of fatal delayed hemothorax after blunt trauma to the chest. When the deceased was transferred to the hospital, his vital signs were stable; hence, medical attention was focused only on the fracture on right ankle. Three days after the orthopedic surgery, he became unsettled with symptoms similar to delirium and exhibited unstable vital signs; he then suddenly died. On autopsy, a beveled fracture was identified on the posterior aspect of the left second rib with hemothorax. It was because of a rupture in the intercostal artery at the fracture site that a simple fracture in a rib, following a blunt chest trauma can be a potentially life-threatening condition. We suggest that a meticulous examination should be performed at the rib fracture sites when a blunt trauma to the chest is suspected even when there are no internal organ injuries identified except hemothorax.

Keyword

Hemothorax; Rib fractures; Death; Autopsy

MeSH Terms

Aged
Ankle
Arteries
Autopsy
Delirium
Hemothorax*
Humans
Orthopedics
Rib Fractures*
Ribs*
Rupture
Thorax
Vital Signs

Figure

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  Fig. 1. Fracture of the left second rib without dislocation was noted at the posterior side of the left thoracic cavity.

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  Fig. 2. Blood (2,000 mL) filling in the left thoracic cavity made the left lung collapsed.

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  Fig. 3. The parietal pleura was ruptured at the posterior side of the left thoracic cavity.

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