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 Deep Fryer Filter Bags 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 Power Inlet 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.