Published in:
01-10-2018 | Imaging in Intensive Care Medicine
Pulsatile bleeding after sternal bone marrow puncture
Published in: Intensive Care Medicine | Issue 10/2018
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A 66-year-old man suffering from autoimmune myositis underwent a sternal bone marrow puncture. The procedure was performed by an experienced hematologist. Pulsatile bleeding occurred immediately after the internal needle was removed. The needle was immediately replaced (Fig. 1). A contrast-enhanced thoracic computed tomography (CT) scan with 3D reconstruction was performed. The CT scan revealed that the needle was penetrating the ascending aorta, through venomous trunk (Figs. 2, 3). The median distance between the skin surface and the aorta is typically 23.6 and 21.3 mm in men and women, respectively. It was around 32.8 mm for our patient, while the length of our needle was 30 mm (Fig. 4).
Figs. 1–4
1 Bone marrow needle and trocar in place just before thoracic CT scan. 2 Contrast-enhanced sagittal thoracic CT scan in the arterial phase showing the trocar through the sternum. 3 Coronal thoracic CT scan with 3D reconstruction. 4 Contrast-enhanced scan in the arterial phase showing distance between the skin surface and the aorta
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