Extrapleural hematoma: when is surgery indicated?

Poyraz, A.S.; Kılıç, Dalokay; Gültekin, Bahadır; Özülkü, Mehmet; Hatipoğlu, Ahmet

doi:10.4081/monaldi.2005.636

Cited by 26 publications

(30 citation statements)

References 4 publications

(8 reference statements)

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“…Poyraz et al 2 recommended medical therapy or simple observation when the vital signs of the patient are stable and the hematoma is small; and surgical treatment is required if the hematoma is huge, causing circulatory and ventilatory disturbances, or the condition of patient is unstable because of active bleeding, as in our case.…”

Section: Discussionmentioning

confidence: 90%

“…1 It has been reported that extrapleural hematoma can be caused by chest trauma or iatrogenic complications at the time of central venous catheterization, rupture of an aneurysm of the thoracic aorta, pleural biopsy, or even spontaneous rib fracture. 2 The diagnosis of extrapleural hematoma can be confi rmed by chest radiography. The typical fi nding of extrapleural hematoma is a D-shaped opacity with its base located against the corresponding part of the chest wall.…”

Section: Discussionmentioning

confidence: 99%

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Rapidly expanding extrapleural hematoma

Igai

Okumura

Ohata

et al. 2008

Gen Thorac Cardiovasc Surg

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We present a rare case of extrapleural hematoma due to chest trauma in an anticoagulated male patient. Chest computed tomography revealed multiple left rib fractures and a D-shaped opacity in the upper left side of the thorax suggesting extrapleural hematoma, which was caused from continuous bleeding. His past history included alcoholic liver cirrhosis, which caused thrombocytopenia and coagulopathy. Therefore, the hematoma was expanding, causing circulatory and ventilatory disturbance and severe anemia despite the difficulty of expanding in the extrapleural space. As the bleeding did not stop, even after intercostal artery angiography with embolization was performed, surgical treatment was undertaken to control the bleeding and evacuate the huge hematoma. The problems associated with the diagnosis and treatment of an extrapleural hematoma are discussed in the light of this case.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Rapidly expanding extrapleural hematoma

Igai

Okumura

Ohata

et al. 2008

Gen Thorac Cardiovasc Surg

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“…[1] Among the differential diagnosis are encysted pleural effusion, pleural tumors, peripheral lung tumors, oleothorax, round atelectasis and diaphragmatic hernias. [1,6] …”

Section: Discussionmentioning

confidence: 99%

“…[1] On the other hand, some studies have stated that VATS is the appropriate method to explore the extrapleural area, evacuate the hematoma by opening the parietal pleura and determine the bleeding center. [5,6] We also think that in cases where tube thoracostomy fails to provide adequate drainage and EPH is suspected, VATS should be the first preference. If VATS does not yield good results, then hematoma should be drained with thoracotomy.…”

Section: (A) (B) (C)mentioning

confidence: 99%

Extrapleural hematoma cases treated with video-assisted thoracic surgery

Pirzirenli

Çelik

Gürz

et al. 2015

Ulus Travma Acil Cerrahi Derg

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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.

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“…7 Compared with reported cases of extrapleural hematoma, our case was categorized as a large hematoma, for which surgical removal is usually recommended. 1, 8 We chose close observation rather than another treatment for her extrapleural hematoma because the patient was…”

Section: Discussionmentioning

confidence: 99%

Extrapleural hematoma as a complication following thoracotomy for pulmonary lobectomy

Noguchi

Hida

Kaga

et al. 2011

Gen Thorac Cardiovasc Surg

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Extrapleural hematoma as a complication following thoracic surgery is rare. We report a case of an extrapleural hematoma following pleural lobectomy that resolved completely with nonsurgical treatment. A 63-year-old woman underwent left lower lobectomy for lung cancer through a left posterolateral thoracotomy. She had been prescribed the anticoagulant cilostazol to increase her heart rate for atrioventricular dissociation. Preoperatively, it was stopped, and a temporary pacemaker was placed to counteract bradycardia via the right jugular vein without complication. The chest tube was removed, and cilostazol was resumed on the third postoperative day. On day 7, she suddenly experienced left shoulder pain followed by hypotension, tachycardia, and anemia. Enhanced computed tomography (CT) revealed an extrapleural hematoma rather than a hemothorax. She became symptomatic after rapid infusion. The hematoma resolved without an invasive intervention. The CT results 189 days after the onset showed almost complete regression of the hematoma.

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Extrapleural hematoma: when is surgery indicated?

Cited by 26 publications

References 4 publications

Rapidly expanding extrapleural hematoma

Rapidly expanding extrapleural hematoma

Extrapleural hematoma cases treated with video-assisted thoracic surgery

Extrapleural hematoma as a complication following thoracotomy for pulmonary lobectomy

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