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Life in the Fast Lane Medical Blog Intercostal Antidote to Hubris

Next time you get ready to Own the Chest Tube, think about these 2 angiography images of the course of the intercostal arteries.

No Ethel, the intercostals aren’t stuck firmly to the inferior margin of the rib.They wander all over creation. Perhaps, they intentionally wiggle and try to impale themselves on the tip of your needle. I believe that one vessel in the second image crosses the equator into northern Queensland.

Yoneyama H, Arahata M, Temaru R, Ishizaka S, Minami S. Evaluation of the risk of intercostal artery laceration during thoracentesis in elderly patients by using 3D-CT angiography. Intern Med. 2010;49(4):289-92. Epub 2010 Feb 15. PMID: 20154433.

Here’s the free fulltext link for you: http://www.jstage.jst.go.jp/article/internalmedicine/49/4/289/_pdf

Thanks to Erik Adler, MD  for finding this truly obscure but thoroughly frightening little article.

Life in the Fast Lane Medical Blog - Emergency Medicine education blog