Massive hemothorax following CT-guided lung biopsy: A rare iatrogenic complication managed conservatively

TL;DR

A rare case of massive hemothorax after a lung biopsy was successfully treated without surgery in a stable patient.

Contribution

Demonstrates successful conservative management of a life-threatening complication following a lung biopsy.

Findings

A 35-year-old woman developed a massive hemothorax after a CT-guided lung biopsy.

Conservative management led to complete recovery without surgical intervention.

Trauma-based principles were effective in managing the complication.

Abstract

CT-guided transthoracic lung biopsy is an essential diagnostic technique for evaluating pulmonary lesions. Although rare, major complications such as hemothorax can be life-threatening. We report the case of a 35-year-old woman who developed a rapidly enlarging right hemothorax several hours after CT-guided core needle biopsy of a pleura-abutting right lower lobe mass. There was no arterial extravasation, and chest tube drainage yielded approximately 1500 mL of dark, clotted blood, suggesting a venous or tumoral source. The patient remained hemodynamically stable and achieved complete recovery with conservative management. This case highlights that even massive post-biopsy hemothorax can be successfully treated non-operatively in stable patients by adhering to trauma-based management principles.

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