A hemothorax is a collection of blood in the space between the chest wall and the lung (the pleural cavity).
The most common cause of hemothorax is chest trauma. It can also occur in patients who have:
- A defect of blood clotting
- Blunt trauma to the chest
- Death of lung tissue (pulmonary infarction)
- Lung or pleural cancer
- Penetrating chest trauma (when a weapon such as a knife or bullet cuts the lung)
- Placement of a central venous catheter
- Thoracic or heart surgery
The most common symptoms of a hemothorax are:
- Chest pain
- Rapid heart rate
- Shortness of breath
Your doctor may note decreased or absent breath sounds on the affected side. Signs of hemothorax may be seen on the following tests:
- Chest x-ray
- CT scan
- Pleural fluid analysis
The goal of treatment is to stabilize the patient, stop the bleeding, and remove the blood and air in the pleural space. A chest tube is inserted through the chest wall to drain the blood and air. It is left in place for several days to re-expand the lung.
When a hemothorax is severe and a chest tube alone does not control the bleeding, surgery (thoracotomy) may be needed to stop the bleeding.
The cause of the hemothorax should be also treated. In trauma patients, depending on the severity of the injury, chest tube drainage is often all that is necessary. Surgery is often not required.
The outcome depends on the cause of the hemothorax and how quickly treatment is given.
Possible complications to a hemothorax include:
- Collapsed lung, leading to respiratory failure
- Fibrosis or scarring of the pleural membranes
An emergency medical professional should be contacted if there is any serious injury to the chest, chest pain or shortness of breath. Medical treatment is required if there is severe chest pain, extreme difficulty in breathing, or any of the above symptoms of a hemothorax.
Use safety measures (such as seat belts) to avoid injury. Depending on the cause, a hemothorax may not be preventable.
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