Ruptured intercostal aneurysm is a rare cause of spontaneous hemopneumothorax (SHP). A 29-year-old woman presented to our hospital with left neck pain and, in the emergency room, suddenly lost consciousness. Chest radiography showed massive pleural effusion and the moderate collapse of the left lung. A chest drain was placed and 800 mL of bloody pleural effusion was collected. Contrast-enhanced computed tomography showed a ruptured aneurysm near the left pulmonary apex. Emergency angiography further revealed the ruptured aneurysm in the second intercostal artery. Transcatheter angiographic embolization (TAE) was performed, which resulted in hemostasis. On hospitalization day 2, the hematoma was removed via video-assisted thoracic surgery. A bulla was also identified in the lower lobe and removed. She was discharged from the hospital on a postoperative day 6 without complications. Thus, TAE might be effective to control bleeding during the initial treatment of SHP due to a ruptured aneurysm.

破裂的肋间动脉瘤是自发性血气胸 (SHP) 的罕见原因。一名 29 岁女性因左颈部疼痛就诊于我们医院，并在急诊室突然失去知觉。胸片显示大量胸腔积液和左肺中度塌陷。放置胸腔引流管并收集 800 mL 血性胸腔积液。对比增强计算机断层扫描显示左肺心尖附近的动脉瘤破裂。急诊血管造影进一步揭示了第二肋间动脉破裂的动脉瘤。进行了经导管血管造影栓塞术 (TAE)，导致止血。住院第 2 天，通过电视辅助胸外科手术清除血肿。在下叶也发现了一个大泡并被移除。她在术后第 6 天出院，没有出现并发症。因此，TAE 可能在 SHP 初始治疗期间因动脉瘤破裂而有效控制出血。