CTICasesExtrapleural Hematoma
Imaging findings
Chest radiograph and chest CT demonstrate a large, hyperattenuating chest wall mass with convex margins pointing internally and tapering edges along the pleura (incomplete border sign). A displaced extrapleural fat line is visible, confirming the extrapleural location. A chest tube placed in the pleural space failed to drain the collection, which was subsequently evacuated surgically.
Key takeaways
Extrapleural hematomas typically occur secondary to chest wall trauma or intercostal vessel injury. On imaging, they are characterized by the incomplete border sign and displacement of the extrapleural fat. Unlike pleural fluid collections, extrapleural hematomas cannot be drained via standard thoracostomy tubes and often require surgical evacuation or targeted drain placement.
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