Clinical history

A 22-year-old man was transported to our emergency department after he was stabbed in the chest and suffered from pain in the back. At physical examination, this patient had no respiratory problems, with a breathing frequency of 15/min and an oxygen saturation of 98%. No circulatory problems were noted.

Radiological images

Radiological findings

An additional line is observed at the lateral part of the left hemithorax (arrow), suggesting a pneumothorax. A chest drain was placed. There was an increased opacity of the left hemithorax suggesting the presence of a haemothorax. A widened, abnormal mediastinum with indistinct delineation, depression of the left main bronchus, left apical capping, and opacification of the aortoplumonary window suggesting mediastinal bleeding.

CT findings

(1), (2) Coronal and sagittal MDCT reconstructions of the chest with highly concentrated intravenous contrast demonstrated presence of a chest drain (white arrow) and its correct position (not shown), a large mediastinal haematoma, a haemothorax and a filling defect at the dorsal part of the descending aorta (black arrow). (3) In addition, MDCT demonstrated a residual (ventral) pneumothorax (arrow).

Extra Examinations

No EXTRA EXAMINATIONS for this particular case.

Final diagnosis

Penetrating injury to the chest resulting in: a haemopneumothorax - an aortic laceration that was treated without aortic stenting At a follow-up CT scan after three months, the filling defect and the mediastinal haematoma had disappeared without signs of pseudoaneurysm.

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