Spontaneous Hemopneumothorax - Results of Conservative Treatment

Abstract

Spontaneous hemopneumothorax is a serious condition complicating spontaneous pneumothorax. Early stage thoracotomy has been advocated to stop the bleeding and evacuate the coagulated blood from the pleural cavity. The present review was undertaken to emphasize the potential life-threatening condition of spontaneous hemopneumothorax and reassess the benefit of conservative treatment with chest tube drainage. Out of six patients, five patients were treated conservatively and one required an emergency thoracotomy because of cardiovascular collapse. Although three patients still had minimal residual hemopneumothorax on discharge, none of them developed empyema or trapped lung. In conclusion, conservative treatment is efficient and should be performed if bleeding persists for less than 24 hours after chest tube placement.

Video-assisted thoracic surgery for primary spontaneous hemopneumothorax

“…In the past, a conservative approach with tube thoracostomy, as for uncomplicated pneumothorax, has be used in selected group of SHP patients where bleeding subsides in 24 h [13]. However, all our patients required surgical intervention during the hospital stay because of hemodynamic instability, complications related to the SHP or persistent air leak with pneumothorax.…”

Diagnosis and treatment of primary spontaneous pneumothorax

“…The bleeding usually originates from the ruptured aberrant blood vessels on the surface of bullae/blebs, which adhered to the chest wall (Tsukioka et al, 1989). Earlier reports suggest that SHP can be treated with chest tube insertion (de Perrot et al, 2000), and surgical intervention is reserved for patients with massive bleeding and hemodynamic instability, persistent bleeding for more than 24 h or retained blood clots refractory to tube drainage (Hart et al, 2002). Since VATS has gradually replaced open thoracotomy as the standard surgical approach for patients with PSP, its minimal invasiveness, excellent safety, and effectiveness makes it the primary treatment for SHP (Miyazawa et al, 2002;Luh and Tsao, 2007).…”

Spontaneous tension haemopneumothorax

“…Tüp torakostomi tek başına spontan hemopnömotoraks için konservatif tedavi olarak gözükmekte-dir (1,5). Operasyon için endikasyonlar ise, hipovolemik şok, devam eden kanama (> 100 mL/saat), devam eden hava kaçağı ve ampiyemdir (6).…”