Hemothorax

What is hemothorax?

Hemothorax is the presence of blood in the pleural cavity, that is, between the chest wall and the lungs. The most common cause is chest trauma.

To perform the treatment, the patient must first be stabilised, then the bleeding stops and the blood and air are removed from the pleural space.

 

Disease prognosis

The prognosis of hemothorax may depend on the cause of the disease. The cause of the disease will influence the amount of blood loss and how quickly treatment begins. In cases where the trauma is more severe, the prognosis will depend on the injury and the amount of bleeding.

X-ray of a patient suffering from hemothorax

Hemothorax symptoms

The symptoms of hemothorax can vary. Among the symptoms are:

• Anxiety
• Chest pain
• Low blood pressure
• Pale and cold skin
• Accelerated heart rate
• Quick and shallow breathing
• Restlessness
• Difficulty breathing

 

How is hemothorax diagnosed?

The specialist will go through a physical examination and look for a decrease in or disappearance of respiratory noises on the affected side. The signs or indications that the patient suffers from hemothorax can be observed through the following tests:

• Chest X-ray
• CT scan
• Pleural fluid analysis
• Thoracentesis (a test that involves draining pleural fluid through a catheter or a needle)

 

What are the causes of hemothorax?

The main cause of hemothorax is usually a blow to the chest. However, this disease can occur in patients suffering from:

• A blood-clotting defect
• Trauma following chest (thoracic) or heart surgery
• Death of lung tissue (pulmonary infarction)
• Lung or pleural cancer
• Rupture to a blood vessel after the placement of a central venous catheter, or when associated with severe high blood pressure
• Tuberculosis

 

Can it be prevented?

The existence of various causes makes prevention difficult. However, in some cases, hemothorax can be prevented. For example, when travelling by car the use of a safety belt can avoid suffering a blow to the chest, one of the causes of hemothorax.

 

Treatments for hemothorax

The main objective of treatment is to achieve stabilisation, interrupt blood loss and extract blood and air from the pleural space. This can be achieved in the following ways:

• A pleural catheter is inserted through the chest wall between the patient's ribs in order to drain blood and air.
• A probe remains in the patient and is subject to suction for days to re-expand the lung.

 

In cases where a catheter cannot control the bleeding, the patient will need surgery (thoracotomy) to stop the bleeding. On the other hand, the cause of hemothorax must also be treated.

 

What specialist treats it?

A thoracic surgeon treats hemothorax. Find a thoracic surgeon through the Top Doctors website.