咳嗽引起肋骨骨折：一個不尋常的急性胸痛的原因

Cough-Induced Rib Fracture: an Unusual Cause of Acute Chest Pain

肋骨骨折是在急診室常見的損傷，其中最常發生鈍性胸外傷，但劇烈或持續咳嗽也能相關的一些併發症，如氣胸和肋骨骨折。我們報告一個 50 歲的男子間歇性的咳嗽8 天，劇烈的陣發性咳嗽發作後右胸痛突然發作。胸部 X 光顯示無異常。其後的胸部電腦斷層發現右第八肋骨側面線性非位移性骨折。如病人表現為長期或嚴重的咳嗽，一但突然胸痛發作時應懷疑咳嗽引起的肋骨骨折。病患接受內科治療改善後隔天就平安出院。

Rib fractures are common injuries seen in the emergency department, and occur most of-ten following blunt thoracic trauma. However, violent or sustained coughing can also cause complications such as pneumothorax and rib fracture. We report a 50-year-old man who pre-sented to the emergency department with an intermittent nonproductive cough for 8 days and sudden onset of right side chest pain after an episode of violent paroxysmal coughing. The initial chest radiograph did not reveal a rib fracture. Subsequent chest computed tomography demonstrated a linear nondisplaced fracture at the lateral aspect of the right 8th rib. The pa-tient gradually improved after medical treatment and was discharged the next day.