CTICasesDelayed Hemothorax Post-First Rib Resection for Thoracic Outlet Syndrome
Imaging findings
Immediate post-operative chest radiograph after partial right first rib resection demonstrates a small, expected amount of apical extrapleural fluid. However, six days later, a repeat radiograph reveals a large, rapidly accumulating right-sided pleural effusion, which upon drainage was confirmed to be a large, bloody hemothorax.
Key takeaways
First rib resection is a common surgical treatment for thoracic outlet syndrome. While the immediate post-operative course may appear uneventful, patients are at risk for delayed hemothorax, which can be exacerbated by post-operative anticoagulation therapy. Close clinical and radiographic follow-up is necessary to detect delayed hemorrhagic complications.
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