Fig. 2

CT scan with contrast medium and Volume rendering of the active bleeding. The Axial CT scan (a) shows the blushing of contrast media in the right lung apex (star) that crosses into a blood clot. The volume rendering reconstruction (b) with a back view of the subclavian artery highlights its passage between the clavicle and the first rib. The three-dimensional reconstruction shows also, two vessels arising from the superior side of the artery, the thick white arrow points the thyrocervical trunk while the star indicates the outflow of contrast media. In the CT slice (c) are detectable: the right lung collapse (arrowheads), the presence of an air-fluid level (dashed line) with a dishomogeneous avascular irregular-shaped mass in the posterior pleural cavity as hallmark of a haemo-pneumothorax with huge coagulated blood (asterisk) and, lastly, the consequent mediastinal left-shifting