Hemothorax

Hemothorax
Other namesHaemothorax, haemorrhagic pleural effusion
PMC2567296 1757-1626-1-225-2.png
Chest X-ray showing left sided hemothorax (arrowed)
SpecialtyPulmonology
SymptomsChest pain, difficulty breathing
ComplicationsEmpyema, Fibrothorax
TypesTraumatic, spontaneous
CausesTrauma, rare conditions
Diagnostic methodX-ray, ultrasound, CT scan, MRI, thoracentesis
TreatmentTube thoracostomy, thoracotomy fibrinolytic therapy
MedicationStreptokinase, urokinase
PrognosisFavorable with treatment
Frequency300,000 cases in the US per year

A hemothorax (derived from hemo- [blood] + thorax [chest], plural hemothoraces) is an accumulation of blood within the pleural cavity. The symptoms of a hemothorax include chest pain and difficulty breathing, while the clinical signs include reduced breath sounds on the affected side and a rapid heart rate. Hemothoraces are usually caused by an injury but may occur spontaneously: due to cancer invading the pleural cavity, as a result of a blood clotting disorder, as an unusual manifestation of endometriosis, in response to a collapsed lung, or rarely in association with other conditions.

Hemothoraces are usually diagnosed using a chest X-ray, but can be identified using other forms of imaging including ultrasound, a CT scan, or an MRI scan. They can be differentiated from other forms of fluid within the pleural cavity by analysing a sample of the fluid, and are defined as having a hematocrit of greater than 50% that of the person's blood. Hemothoraces may be treated by draining the blood using a chest tube, but may require surgery if the bleeding continues. If treated, the prognosis is usually good. Complications of a hemothorax include infection within the pleural cavity and the formation of scar tissue.

Signs and symptoms

The symptoms of a hemothorax depend on the quantity of blood that has been lost into the pleural cavity. A small hemothorax usually causes little in the way of symptoms, while larger hemothoraces commonly cause breathlessness and chest pain, and occasionally lightheadedness. Other symptoms may occur in association with a hemothorax depending on the underlying cause.[1]

The clinical signs of a hemothorax include reduced or absent breath sounds and reduced movement of the chest wall on the affected side.[1] When the affected side is tapped or percussed, a dull sound may be heard in contrast to the usual resonant note.[2] Large hemothoraces that interfere with the ability to transfer oxygen may cause a blue tinge to the lips (cyanosis). In these cases the body may try to compensate for the loss of blood, leading to a rapid heart rate (tachycardia), and pale, cool, clammy skin.[3]

Other Languages
العربية: تدمي الصدر
беларуская: Гематоракс
català: Hemotòrax
Deutsch: Hämatothorax
español: Hemotórax
euskara: Hemotorax
français: Hémothorax
italiano: Emotorace
қазақша: Гемоторакс
Nederlands: Hemothorax
日本語: 血胸
português: Hemotórax
română: Hemotorax
русский: Гемоторакс
српски / srpski: Хемоторакс