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A novel, minimally invasive approach to assure hemostasis for intercostal bleeding after trauma

Park, Habeeba, MD; Glaser, Jacob, MD; Florecki, Katherine, MD; Schmoekel, Nathan, DO; DuBose, Joseph, MD; Stein, Deborah, MD; Scalea, Thomas, MD

Journal of Trauma and Acute Care Surgery: June 2018 - Volume 84 - Issue 6 - p 1027–1029
doi: 10.1097/TA.0000000000001853

ABSTRACT Intercostal artery injury can cause large hemothoraces. While many patients with intercostal artery injury present hemodynamically unstable and require emergent thoracotomy for hemostasis, some tamponade spontaneously. They may rebleed later, however, and cause recurrent hemothorax or retained hemothorax. Video-assisted thoracic surgery (VATS) is an effective way to evacuate retained hemothorax. However, assessing and ligating intercostal artery injury during VATS can be difficult, and often, open thoracotomy is pursued. Even with open surgery, ligation of the intercostal artery can be a challenge. We present a minimally invasive method of definitive intercostal artery ligation during VATS or open thoracotomy.

From the University of Maryland Shock Trauma Center (H.P., J.G., N.S., J.D., D.S., T.S.); and Sinai Hospital (K.F.), Baltimore, Maryland.

Submitted: January 29, 2018, Revised: January 31, 2018, Accepted: February 6, 2018, Published online: February 20, 2018.

Presented at the 2014 Society of American Gastrointestinal and Endoscopic Surgeons Annual Meeting April 2–5 2014, Salt Lake City, UT (poster presentation).

Address for reprints: Habeeba Park MD, University of Maryland Shock Trauma Center, 22S Greene St, Baltimore, MD 21201; email:

© 2018 Lippincott Williams & Wilkins, Inc.