LEFT HEMOTHORAX: UNUSUAL MANIFESTATION OF AORTIC DISSECTION

Abstract

Aortic dissection is a medical and surgical emergency often revealed by acute chest pain. Its discovery in the context of hemorrhagic pleurisy is rare, and it often poses a diagnostic challenge.We report the case of a 52-year-old patient with a history of chronic smoking, without known arterial hypertension, admitted forexploring a moderately abundant left pleural effusion. Pleural puncture yielded non-coagulable hemorrhagic fluid. Thoracic angio-CT scan revealed a type B aortic dissection (Stanford classification). In the absence of surgical indication, antihypertensive treatment was initiated in this patient, combined with close medical monitoring. The course was marked by the death of the patient after refractory hemorrhagic shock.Aortic dissection should be systematically considered in the presence of any spontaneous hemothorax, even in the absence of suggestive clinical signs.