Conservative Management of Azygous Vein Rupture in Blunt Thoracic Trauma

Abstract EN

We report a case of successful conservative management of acute traumatic rupture of the azygous vein.

A 48-year-old male was involved in a motor vehicle collision.

Primary survey revealed acute right intrathoracic haemorrhage.

He remained haemodynamically stable with rapid infusion of warmed crystalloid solution and blood.

Computed tomographic imaging showed a contained haematoma of the azygous vein.

The patient was managed conservatively in the intensive care.

Azygous vein laceration resulting from blunt thoracic trauma is a rare condition that carries a universally poor prognosis unless the appropriate treatment is instituted.

Clinical features include acute hypovolaemic shock, widened mediastinum on chest radiograph, and a right-sided haemothorax.

Haemodynamic collapse necessitates immediate resuscitative thoracotomy.

Interest in this injury stems from the severity of the clinical condition, difficulty in diagnosis, the onset of a rapidly deteriorating clinical course all of which can be promptly reversed by timely and appropriate treatment.

Although it is a rare cause of intramediastinal haemorrhage, it is proposed that a ruptured azygous vein should be considered in every trauma case causing a right-sided haemothorax or widened mediastinum.

All cases described in the literature to date involved operative management.

We present a case of successful conservative management of this condition.