We report a case of intercostal artery laceration, resulting from needle aspiration of the chest, in a preterm infant with respiratory distress syndrome. The laceration resulted in severe hemorrhage and shock. Pressure dressings applied over the chest did not stem the bleeding, and dissection of the artery and ligation were necessary. Early diagnosis and management with infusions of blood and plasma contributed to the successful outcome. Intercostal artery laceration can be a major complication of needle aspiration of the chest for pneumothorax.
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References
1.
DavisCH, StevensGW. Value of routine radiographic examinations of the newborn, based on a study of 702 consecutive babies. Am J Obstet Gynecol1930;20:73–76.
2.
ChernickV, AveryME. Spontaneous alveolar rupture in newborn infants. Pediatrics1963;32:816–824.
3.
ChernickV, ReedMH. Pneumothorax and chylothorax in the neonatal period. J Pediatr1970;76:624–632.
4.
KirkpatrickBV, FelmanAH, EitmanDV. Complications of ventilator therapy and respiratory distress syndrome: Recognition and management of acute air leaks. AJDC1980;128:496–502.
5.
ShimWKT, PhilipAGE. Danger of needle aspiration in pneumothorax in the newborn. JAMA1973;223:691.
6.
JungAL, MintonSD, RoanY.Pulmonary hemorrhage secondary to chest tube placement for pneumothorax in neonates. Clin Pediatr1980;19:624–627.
7.
MoessingerAC, DriscollJM, WiggerHJ. High incidence of lung perforation by chest tube in neonatal pneumothorax. J Pediatr1978;92:635–637.
8.
ShreinerRL, ed. Care of the newborn. New York: Raven Press, 1961;158,268-269.
9.
AllenRW, JungAL, LesterPD. Effectiveness of chest tube evacuation of pneumothorax in neonates. J Pediatr1981;99:629–632.
10.
HolmsSL, MarksJBD. Simple apparatus for underwater seal in pneumothorax of newborn. J Pediatr Surg1968;3:87–88.
11.
Van HeerdenJB, LanfenbergJHJr. Simplified thoracentesis. Mayo Clin Proc1968;43:311.
12.
HillA, PerlmanJM, VolpeJJ. Relationship of pneumothorax to occurrence of intraventricular hemorrhage in the premature newborn. Pediatrics1982;69:144–149.
13.
DykesFD, LazzarraA, AlmannP, . Intraventricular hemorrhage: A prospective evaluation of etiopathogenesis. Pediatrics1980;66:42–49.
14.
LipscombAP, ThornburnRJ, ReynoldsEOR, . Pneumothorax and cerebral hemorrhage in preterm infants. Lancet1981;1:414–416.
15.
KuhnsL, BednarekFJ, WymanM, . Diagnosis of pneumothorax or pneumomediastinum in the neonate by transillumination. Pediatrics1975;56:355–360.
