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(a) Chest X-ray on admission showed no evidence of hemothorax.. (b) Chest X-ray showed massive left hemothorax and deviation of the trachea.
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On hospital admission, no left hemothorax was detected (Fig. 1a); therefore, conservative therapy was administered and he was admitted to the emergency ward and placed on bedrest. A chest radiograph showed a left massive hemothorax with a mediastinal shift (Fig. 1b).
Chest contrast-enhanced CT showed a massive left hemothorax, and extravasation in front of the 11th left rib fracture.
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Contrast-enhanced computed tomography of the chest following fluid resuscitation revealed extravasation of the contrast agent around the ventral side of the 11th left rib fracture (Fig. 2).
(a) Under thoracoscopy, active bleeding from the left hemidiaphragm was seen.. (b) Suture hemostasis of the diaphragmatic injury and repair of the fractured ribs.
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The diaphragmatic injury was treated with suture hemostasis, and the fractured rib was repaired (Fig. 3).