Correct!
4. The enhanced thoracic CT shows active bleeding in the left pleural space
The enhanced thoracic CT shows hyperattenuation paralleling the internal aspect of the left thorax, which represents active extravasation of contrast-enhanced blood from an injured intercostal artery (Figure 5).
Figure 5. Axial contrast-enhanced thoracic CT shows a large left pleural effusion (*). A thoracostomy tube is present in the left pleural space. There is linear hyperattenuation (arrowheads) in the peripheral left thorax, representing active contrast-enhanced blood extravasating from an injured intercostal artery. More inferiorly in the left pleural space, the pleural liquid appears mildly hyperattenuating and organized, consistent with retracting blood clot.
The heart appears normal, aside from coronary artery calcification, and no pulmonary arterial aneurysm is present. A large left pleural effusion is present, but there is no visible gas in the left pleural space, so no hydropneumothorax is present. The thoracic aorta shows atherosclerosis, but there is no evidence to suggest aortic injury.
Given the CT findings, which of the following choices is most appropriate for the managementof this patient? (Click on the correct answer to proceed to the seventh of eight pages)