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An anusual case of spontaneous hemothorax in an adolescent affected by congenital exostosis: case report and literature review
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  • Giangiacomo Nicolini,
  • Giulio Bove,
  • Monica Micera,
  • Alessandra Bet,
  • Fabio Ricagna
Giangiacomo Nicolini
Ospedale San Martino Belluno

Corresponding Author:[email protected]

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Giulio Bove
Università degli Studi di Padova Dipartimento di Specialità Medico-Chirurgiche
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Monica Micera
Ospedale San Martino Belluno
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Alessandra Bet
Family Pediatrician
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Fabio Ricagna
Ospedale San Martino Belluno
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Abstract

We present the case of a male adolescent with a haemothorax caused by pericardial rupture secondary to costal exostosis. The patient was affected by multiple congenital exostosis and six years earlier he underwent a bone spur resection of the right femur. An X-ray performed at presentation was interpreted as suggestive of pneumonia and the patient was therefore treated with antibiotics without any clinical improvement. A thoracic ultrasonography performed 7 days later showed a massive haemothorax, confirmed by a CT scan on which a pericardial lesion caused by the growth of three osteo-cartilagineous spurs originating from the 5th, 7th and 8th rib was detected. The boy underwent surgery and recovered completely. The thoracic ultrasound and the subsequent CT-scan performed on the patient due to his lack of clinical improvement directed us towards a rare disease that the X-ray had not helped diagnose; this entailed the prompt surgical resolution of a possibly severe, maybe even fatal, condition.