CTICasesTraumatic Extrapleural Hematoma from Intercostal Vessel Injury
Imaging findings
An older patient with prior CABG fell onto the right side and has an ill-defined opacity without a clear interface with lung, representing a large extrapleural hematoma. There is a displaced extrapleural fat sign, and scrolling down reveals a rib fracture with a disrupted intercostal vessel as the bleeding source; angiography cannulated and embolized the intercostal vessel.
Key takeaways
A large extrapleural hematoma from a fractured rib and disrupted intercostal vessel can appear as an ill-defined opacity lacking a discrete lung interface, and the displaced extrapleural fat sign confirms its extrapleural location. Identifying the culprit fractured rib and bleeding intercostal vessel allows targeted angiographic embolization.
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