Hemothorax

A hemothorax (or haemothorax) is a condition that results from blood accumulating in the pleural cavity. Its cause is usually traumatic, from a blunt or penetrating injury to the thorax, resulting in a rupture of either of the serous membrane lining the thorax and covering the lungs. This rupture allows blood to spill into the pleural space, equalizing the pressures between it and the lungs. Blood loss may be massive in people with these conditions, as each side of the thorax can hold 30%-40% of a person's blood volume. If left untreated, the condition can progress to a point where the blood accumulation begins to put pressure on the mediastinum and the trachea, effectively limiting the amount of diastolic filling of the ventricles and deviating the trachea to the unaffected side.

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Signs and symptoms

• Tachypnea.
• Dyspnea.
• Cyanosis.
• Decreased or absent breath sounds on affected side.
• Tracheal deviation.
• Dull resonance on percussion.
• Unequal chest rise.
• Tachycardia.
• Hypotension.
• Pale, cool, clammy skin.
• Possibly subcutaneous air.
• Narrowing pulse pressure.

Management

A hemothorax is managed by removing the source of bleeding and by draining the blood already in the thoracic cavity. Blood in the cavity can be removed by inserting a drain (chest tube) in a procedure called a tube thoracostomy. Patients should recover swiftly after this. However, if the cause is rupture of the aorta in high energy trauma, the intervention by a thoracic surgeon is mandatory.

See also

• Cardiac tamponade
• Hemopneumothorax
• Pleural effusion
• Pneumothorax
• Tension pneumothorax