Fig. 3

Comparison of the chest computed tomography images at initial arrival (a1 and a2) and post-embolization (b1 and b2). Pneumothorax and subcutaneous emphysema were recognized at the initial diagnosis by computed tomography and, therefore, a chest drain was inserted. Pulmonary contusion was extremely minor and active bleeding such as the intercostal artery injury was not captured (a1 and a2). A large hemothorax appeared on reexamination by computed tomography after transcatheter arterial embolization (b1 and b2). Similar active bleeding was not observed at the initial diagnosis computed tomography. A large hemothorax of 2500 ml was observed in thoracotomy hemostasis. However, active bleeding requiring hemostasis treatment was not recognized. The inserted chest drain was occluded by blood clots