Traumatic Hemothorax

September 14, 2005
Avra Lykouri, MD

,
V. Archimandriti, MD

,
V. Baili, MD

,
D. Papaioannides, MD

Traumatic hemothorax usually results from penetrating or contused thoracic injuries that lead to rib fracture and damage of intercostal or pulmonary vessels. Hemorrhagic shock can occur with massive blood loss into the pleural space. The shock state may be exacerbated by decreased venous return.

Traumatic hemothorax usually results from penetrating or contused thoracic injuries that lead to rib fracture and damage of intercostal or pulmonary vessels. Hemorrhagic shock can occur with massive blood loss into the pleural space. The shock state may be exacerbated by decreased venous return.

Demonstration of the hemothorax on the initial chest film can be hindered if the patient is supine and the collection of blood is small. Since bleeding may be slow and may not be evident for several hours, serial radiographs must be obtained. The incidence of concomitant pneumothorax is high (about 60% in our experience).

 

This patient was given oxygen, a chest tube was placed, and 2 units of whole blood were transfused. The chest tube was removed after 3 weeks; a second chest film showed almost complete evacuation of the pleural space and reexpansion of the left lung (B).

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