{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:59:03Z","timestamp":1777636743940,"version":"3.51.4"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017585","name":"First Hospital of Jilin University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100017585","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>Internal thoracic artery (ITA) aneurysms are exceedingly rare vascular anomalies that often remain asymptomatic until rupture. Rupture can precipitate acute hemothorax, hemorrhagic shock, and death if not rapidly diagnosed and managed. We report the case of a 42-year-old previously healthy female who presented to the emergency department with sudden-onset chest, abdominal, and back pain. Initial CT imaging elsewhere revealed pleural effusion, a non-specific finding. Upon transfer to our institution, emergency computed tomography angiography (CTA) demonstrated a ruptured left ITA pseudoaneurysm with active contrast extravasation and a large left hemothorax. Emergent transcatheter arterial embolization using microcoils achieved definitive hemostasis. Ultrasound-guided chest tube drainage was subsequently performed. The patient recovered uneventfully and was discharged without complications. This case highlights a critical diagnostic pitfall in emergency medicine\u2014ruptured ITA aneurysm masquerading as simple pleural effusion\u2014and underscores the pivotal role of CTA and endovascular therapy in optimizing outcomes. We also review the literature on etiology, diagnostic challenges, and evolving therapeutic strategies for this rare but fatal condition.<\/jats:p>","DOI":"10.3389\/fsurg.2026.1777076","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T05:53:49Z","timestamp":1777442029000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Spontaneous rupture of an internal thoracic artery aneurysm: a rare life-threatening emergency and Its therapeutic challenges"],"prefix":"10.3389","volume":"13","author":[{"given":"Xun","family":"Guo","sequence":"first","affiliation":[{"name":"Comprehensive Surgical Nursing Platform, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuohang","family":"Liu","sequence":"additional","affiliation":[{"name":"Radiology Department, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheng","family":"Liu","sequence":"additional","affiliation":[{"name":"Emergency Surgery Department, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongquan","family":"Fan","sequence":"additional","affiliation":[{"name":"Emergency Nursing Platform, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/S0022-5223(19)40667-3","article-title":"Peristernal wiring in closure of median sternotomy. 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