A 48-Year-Old Man Presenting as an Emergency with Severe Back Pain, a Large Anterior Paravertebral Hematoma, and Spontaneous Rupture of the Right 9th Intercostal Artery Successfully Managed by Transcatheter Arterial Embolization: A Case Report

Shintaro Izumoto; Tomohiro Abe; Takatoshi Koroki; Eiji Furukoji; Rie Masuda; Hidenobu Ochiai

doi:10.12659/AJCR.934173

16 February 2022 : Case report Japan

A 48-Year-Old Man Presenting as an Emergency with Severe Back Pain, a Large Anterior Paravertebral Hematoma, and Spontaneous Rupture of the Right 9th Intercostal Artery Successfully Managed by Transcatheter Arterial Embolization: A Case Report

Challenging differential diagnosis, Management of emergency care, Rare disease

Shintaro Izumoto^1ABDEF*, Tomohiro Abe^1ACDEF, Takatoshi Koroki^1BCEF, Eiji Furukoji^2ACD, Rie Masuda^2ACD, Hidenobu Ochiai^1ACEF

DOI: 10.12659/AJCR.934173

Am J Case Rep 2022; 23:e934173

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Table 2. Summary of previous cases and the present case with spontaneous intercostal artery rupture without known underlying disease.

Ref	Author	Year	Age	Sex	Symptoms	Hemodynamic status	Bleeding site
[]⁷	Moon	2008	45	Male	Right flank pain	Stable	Retroperitoneum
[]⁸	Mathew	2008	69	Male	Left chest pain	Shock	Left thorax, left abdominal wall
[]⁹	Dobrilovic	2013	62	Female	Chest and back pain	Shock	Left thorax
[]¹⁰	Dua	2014	47	Male	Right chest pain, dyspnea	Shock	Right thorax
[]¹¹	Ishida	2014	58	Male	Back pain	Stable	Posterior mediastinum
[]¹²	Jang	2015	39	Male	Left flank pain	Stable	Left abdominal wall
[]¹³	Junck	2015	63	Male	Back pain	Stable	Posterior mediastinum
[]¹⁴	Tanaka	2021	29	Female	Left neck pain, disorientation	Shock	Left thorax
Present case		2021	48	Male	Back pain	Stable	Posterior mediastinum
Ref. – reference; CT – computed tomography; CXR – chest X-ray; MRI – magnetic resonance imaging; MRA – magnetic resonance angiography; AXR – abdominal X-ray; ND – not described; TAE – transcatheter arterial embolization; VATS – video-assisted thoracic surgery.
Ref	Key image tests	Ruptured intercostal artery	Side	Treatments	Complication	Outcome
[]⁷	CT	10 and 11	Right	TAE	None	Alive
[]⁸	Cxp, CT	10	Left	TAE	None	Alive
[]⁹	MRI, MRA	ND	Left	TAE	ND	Alive
[]¹⁰	CT	11	Right	Thoracotomy	None	Alive
[]¹¹	CT	10	Right	Conservative	None	Alive
[]¹²	Axp, CT	11	Left	Conservative	None	Alive
[]¹³	CT	8	Right	TAE	None	Alive
[]¹⁴	Cxp, CT	2	Left	TAE+VATS	None	Alive
Present case	CT	9	Right	TAE	None	Alive
Ref. – reference; CT – computed tomography; CXR – chest X-ray; MRI – magnetic resonance imaging; MRA – magnetic resonance angiography; AXR – abdominal X-ray; ND – not described; TAE – transcatheter arterial embolization; VATS – video-assisted thoracic surgery.

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A 48-Year-Old Man Presenting as an Emergency with Severe Back Pain, a Large Anterior Paravertebral Hematoma, and Spontaneous Rupture of the Right 9th Intercostal Artery Successfully Managed by Transcatheter Arterial Embolization: A Case Report

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