Delayed massive hemothorax requiring surgery after blunt thoracic trauma over a 5-year period: complicating rib fracture with sharp edge associated with diaphragm injury.
- Author:
Sung Wook CHANG
1
;
Kyoung Min RYU
;
Jae Wook RYU
Author Information
- Publication Type:Case Report
- Keywords: Thoracic injuries; Hemothorax; Diaphragm; Rib fractures
- MeSH: Chest Tubes; Diaphragm*; Drainage; Emergencies; Follow-Up Studies; Hemorrhage; Hemothorax*; Humans; Lacerations; Radiography, Thoracic; Rib Fractures*; Ribs*; Thoracic Injuries; Thoracostomy; Thorax
- From: Clinical and Experimental Emergency Medicine 2018;5(1):60-65
- CountryRepublic of Korea
- Language:English
- Abstract: Delayed massive hemothorax requiring surgery is relatively uncommon and can potentially be life-threatening. Here, we aimed to describe the nature and cause of delayed massive hemothorax requiring immediate surgery. Over 5 years, 1,278 consecutive patients were admitted after blunt trauma. Delayed hemothorax is defined as presenting with a follow-up chest radiograph and computed tomography showing blunting or effusion. A massive hemothorax is defined as blood drainage >1,500 mL after closed thoracostomy and continuous bleeding at 200 mL/hr for at least four hours. Five patients were identified all requiring emergency surgery. Delayed massive hemothorax presented 63.6±21.3 hours after blunt chest trauma. All patients had superficial diaphragmatic lacerations caused by the sharp edge of a broken rib. The mean preoperative chest tube drainage was 3,126±463 mL. We emphasize the high-risk of massive hemothorax in patients who have a broken rib with sharp edges.
