Extrapleural hematoma cases treated with video-assisted thoracic surgery

Abstract

Extrapleural hematoma is a rare clinical condition whose most common causes are blunt chest trauma, central venous catheterization and ruptured thoracic aortic aneurysm. This study aimed to present three cases that underwent video-assisted thoracoscopic surgery due to extrapleural hematoma. Etiologic factors in these cases were falls from height in two cases and a dialysis catheter placed into the right internal jugular vein in one case.

Combined Extra- and Intrapleural Hematoma After Blunt Chest Injury in an Anticoagulated Patient

“…A review of these papers showed 10 case reports, discussing 11 cases of extrapleural hematoma secondary to blunt trauma. Of these, three cases involved patients on anticoagulation [4-6]. In his autopsy study, Ezaki et al identified a hematoma wall composed of parietal pleura, sub-pleura, an extrapleural fat layer, and endothoracic fascia.…”

“…For smaller hematomas, VATS was not considered a good treatment option, as it becomes difficult to visualize the anatomical cavity created by this combined hematoma. However, with larger hematoma cavities, VATS has been shown to be a viable option [4,12-13]. If VATS fails to provide adequate drainage due to difficult anatomic location or the presence of an extremely large hematoma, an open procedure may provide more expedited and complete drainage [13].…”