Extrapleural Hematomas

Chung, Jonathan H.; Carr, Robert B.; Stern, Eric J.

doi:10.1097/rti.0b013e3181ebeaba

Cited by 35 publications

(5 citation statements)

References 12 publications

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“…Extrapleural hematomas occur in approximately 7% of patients with blunt chest injuries [1]. These patients almost always have complications of rib fractures and hemothorax [1, 2]. Hemothorax after thoracic trauma can result in serious conditions, such as hemorrhagic shock.…”

Section: Discussionmentioning

confidence: 99%

“…Several cases of conservative treatment for extrapleural hematomas including observation or image-guided drainage have been reported [3, 4]. Regarding the indications for surgical treatment, Chung et al reported that a biconvex extrapleural hematoma on CT tended to be larger than other types (nonconvex), and surgical intervention might be necessary [2]. Rashid et al also reported a single case of a patient who underwent surgical treatment with thoracotomy following insufficient needle aspiration drainage, while conservative treatment with observation and chest X-ray monitoring was performed in the remaining 33 patients with extrapleural hematomas [1].…”

Section: Discussionmentioning

confidence: 99%

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Successful thoracoscopic evacuation of an extrapleural hematoma with delayed symptomatic pleural effusion: a case report

et al. 2019

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Background Traumatic extrapleural hematoma is a rare condition and is usually managed conservatively until spontaneous resolution unless active bleeding or expansion is found. Case presentation An 80-year-old man taking an anticoagulant medication was referred to our hospital after accidentally falling in a street ditch while riding a bike. Chest X-ray and computed tomography (CT) scan showed multiple fractures on ribs 7–9, hemothorax, and extrapleural hematoma in the posterior chest wall. Though the patient’s hemothorax was improved by chest tube drainage, the extrapleural hematoma still remained. He was transferred to another hospital for rehabilitation, but he was readmitted to our hospital because of dyspnea with accumulation of left pleural effusion, including a subpopulation of neutrophils, but without bacterial infection. We performed thoracoscopic evacuation of the hematoma on day 57 after the initial blunt chest trauma. The patient has had no recurrence of pleuritis for 6 months after surgery. Conclusion Since posttraumatic extrapleural hematoma may result in delayed secondary intractable pleural effusion causing dyspnea, careful observation is necessary when considering indications of surgical intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Successful thoracoscopic evacuation of an extrapleural hematoma with delayed symptomatic pleural effusion: a case report

et al. 2019

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“…Based on CT findings, Chung et al. 6 classified EH as bi-convex, commonly caused by arterial bleeding, and non-convex, a smaller volume associated with venous bleeding. Treatment options depend on the patient's clinical condition.…”

Section: Discussionmentioning

confidence: 99%

Extracranial Vertebral Artery Aneurysm Rupture Complicated by Extrapleural Haematoma

Nenadić

Balevic

Milojevic

et al. 2018

EJVES Short Reports

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IntroductionExtracranial vertebral artery aneurysm (EVAA) and extrapleural haematoma (EH) are rare clinical findings most often associated with blunt or penetrating trauma. However, EVAA rupture can be complicated by development of a large EH.ReportA 50 year old man underwent an emergency thrombectomy followed by graft reconstruction of an aorto-bi-femoral bypass. The post-operative course was complicated by respiratory failure and severe anaemia. Computed tomography revealed EVAA rupture and EH, so ligation of EVAA was performed with thoracotomy.DiscussionIn a patient with extensive peripheral vascular disease and rapid development of EH, the rupture of a supra-aortic vessel aneurysm might be considered.

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“…Stenosis of the brachiocephalic vein in association with high venous flow rates can increase venous pressure in the intercostals and bronchial veins of the chest, which in turn could alter local hemodynamics. As pleural fluid resorption is poor in normal conditions, excess pleural fluid formation is expected to occur, leading to unilateral pleural effusion on the same side as that of vein stenosis/thrombosis [ 5 ]. Therefore, the hematoma collected in the extrapleural space instead of the pleural one is putative because of a previous pleuritis with fusion of the two pleuric layers.…”

Section: Case Presentationmentioning

confidence: 99%

Spontaneous bilateral extrapleural hematoma: a case report

Chang

Kuo

2015

J Cardiothorac Surg

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Extrapleural hematoma (EPH) is a rare condition characterized by the accumulation of blood in the extrapleural space. EPH is generally identified by computed tomography (CT), which shows an inward displacement of extrapleural fat due to intrathoracic peripheral fluid accumulation (Ann Ital Chir 75(83): 5, 2004; J Korean Radiol Soc 49: 89–97, 2003; Monaldi Arch Chest Dis 63(3): 166–169, 2005). EPH has been reported to be associated with chest trauma and injuries. However, the correlation between hemodialysis and EPH has not yet been reported. The causes of EPH in a hemodialysis patient have been postulated, which include high venous flow through the arteriovenous fistula that results in an increase in venous pressure stenosis and/or thrombosis of the brachiocephalic and/or subclavian veins. These conditions thereby induce an increase in venous pressure in the intercostals and bronchial veins of the chest. Pleural fluid resorption is rare and excess pleural fluid formation commonly occurs (J Thoracic Imaging 26(3): 218–223, 2011). The occurrence of pleuritis with fusion of the two pleuric layers results in hematoma development in the extrapleural space instead of the pleural space. We present a chronic hemodialysis patient with spontaneous unilateral EPH. The progression to bilateral EPH was noted after VATS procedure. Awareness of EPH and the use of conservative management are key points for the treatment of this rare clinical condition.

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Extrapleural Hematomas

Cited by 35 publications

References 12 publications

Successful thoracoscopic evacuation of an extrapleural hematoma with delayed symptomatic pleural effusion: a case report

Successful thoracoscopic evacuation of an extrapleural hematoma with delayed symptomatic pleural effusion: a case report

Extracranial Vertebral Artery Aneurysm Rupture Complicated by Extrapleural Haematoma

Spontaneous bilateral extrapleural hematoma: a case report

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