ABSTRACT
CT-guided lung biopsy is a widely used procedure for tissue identification. The complications are divided into minor and major with the latter being described as low rate. Hemothorax is reported at a rate of 0.092% and predominantly results from the injury of intercostals or internal mammary arteries. We present the case of 81-year old woman with a right upper lobe mass referred for a CT-guided biopsy. Four hours after the procedure, rapid deterioration of patient's status was observed. A massive hemothorax was reported due to the transection of an intratumoral pulmonary branch. The following management involved successful emergent embolization of the injured branch of the pulmonary artery using a combination of coils and gel foam. One of the theories possibly explaining this extremely rare complication involves the possibility of underlying pulmonary hypertension.
ABSTRACT
Coagulation abnormalities and thrombosis have been recently identified as sequelae of severe infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report a case of severe coagulopathy manifesting with right upper limb arterial and deep vein thrombosis in an 80-year-old male patient with severe COVID-19 associated pneumonia. He clinically deteriorated and received care in the intensive care unit where he was intubated. At that point, his coagulation laboratory tests were deranged, and he eventually developed dry gangrene in his right thumb and index finger, as well as a deep venous thromboembolism in his right axillary vein. Despite receiving treatment dose anticoagulation and undergoing arterial embolectomy, revascularization was unsuccessful. Amputation of the right arm at the level of the elbow was considered, but the patient died from respiratory failure.
