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  4. Hemothorax caused by costal exostosis injuring diaphragm: a case report and literature review

Hemothorax caused by costal exostosis injuring diaphragm: a case report and literature review

Journal of Cardiothoracic Surgery, 2022 · DOI: https://doi.org/10.1186/s13019-022-01984-7 · Published: August 26, 2022

SurgeryMedical ImagingResearch Methodology & Design

Simple Explanation

Osteochondromas, also known as exostoses, are common benign bone tumors. They are often asymptomatic but can cause problems if they grow and irritate surrounding tissues. This paper describes a case where a costal exostosis (bony growth on a rib) caused a hemothorax (bleeding into the chest cavity) in a young girl. The exostosis injured the diaphragm, leading to bleeding. The paper also reviews similar cases reported in medical literature.

Study Duration
Not specified
Participants
1 patient (13-year-old girl) and literature review
Evidence Level
Level 4, Case report and literature review

Key Findings

  • 1
    Injury to the diaphragm is the primary cause of hemothorax caused by costal osteochondroma.
  • 2
    CT scans are helpful in diagnosing costal osteochondroma before surgery.
  • 3
    Surgical intervention should be considered for symptomatic osteochondromas and even asymptomatic ones with inward bony spiculation.

Research Summary

This paper presents a case of hemothorax in a 13-year-old girl caused by a costal exostosis injuring her diaphragm. The authors reviewed similar cases in the literature and found that injury to the diaphragm is a common cause of hemothorax in these situations. They recommend surgical intervention for symptomatic osteochondromas and even prophylactic removal in asymptomatic patients with specific bony spiculation.

Practical Implications

Diagnostic Awareness

Clinicians should consider costal exostosis as a possible cause of hemothorax, especially in young patients presenting with chest pain and pleural effusion.

Imaging Importance

Thoracic CT scans play a crucial role in diagnosing costal osteochondromas and planning appropriate surgical intervention.

Surgical Management

Prophylactic surgical removal of intrathoracic exostoses should be considered even in asymptomatic patients if there is evidence of inward bony spiculation to prevent potential complications.

Study Limitations

  • 1
    The study is limited by being a single case report.
  • 2
    The literature review is restricted to English language articles.
  • 3
    The follow-up period for the presented case is relatively short (6 months).

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