case_images: PMC6218792_01
case_images: Chest radiography on admission revealed mild widening of cardiac silhouette and right pleural effusion.
case_images: CRIEM2018-1948151.001.jpg
case_images: PMC6218792_01_CRIEM2018-1948151.001.jpg
case_images: fig1
case_images: Chest radiography revealed mild widening of the cardiac silhouette and right pleural effusion (Figure 1).
case_images: Contrast computed tomography (CT) scan on the next day of hospitalization. Right internal mammary artery (IMA) is divided into branches. A red arrow shows main branch of IMA and a yellow arrow shows the extravasation at a branch of IMA. There is small anterior mediastinal hematoma (red arrowheads) around the extravasation. Massive bloody pleural effusion is confirmed in the right lung.
case_images: CRIEM2018-1948151.002.jpg
case_images: PMC6218792_01_CRIEM2018-1948151.002.jpg
case_images: fig2
case_images: To identify the source of the bleeding, contrast CT was performed, which revealed small anterior mediastinal hematoma and bloody pleural effusion (Figure 2).
case_images: Three-dimensional contrast CT images. Left posteroanterior oblique view (a) and left-right view (b). The extravasation from a branch of IMA (yellow arrow) is confirmed. A red arrow shows the IMA main branch.
case_images: CRIEM2018-1948151.003.jpg
case_images: PMC6218792_01_CRIEM2018-1948151.003.jpg
case_images: fig3
case_images: Three-dimensional contrast CT demonstrated an extravasation at the branch of the right IMA (Figures 3(a) and 3(b)).