Abstract

CORTES-TELLES, Arturo; MORALES-VILLANUEVA, Carlos Enrique  and  FIGUEROA-HURTADO, Esperanza. Hemothorax: etiology, diagnosis, treatment and complications. Rev. biomédica [online]. 2016, vol.27, n.3, pp.119-126. ISSN 2007-8447.  https://doi.org/10.32776/revbiomed.v27i3.540.

Initial approach of cases with suspected hemothorax begins with a complete clinical history (eg. recent thoracic trauma). The first step is to differentiate hemorrhagic pleural effusion of true hemothorax; then, prompt diagnosis is essential. We must keep in mind, as time progresses, the clot firmly adheres to the lung and pleural surface making it difficult to treat; therefore, any delay in this process diminishes the opportunity to evacuate the hemothorax through conventional thoracostomy with chest tube insertion and pleural drainage. Chest X-ray still the initial study, however, complementary tests should be performed in order to guide therapeutic decisions. The choice must be justified on local availability and experience. Undoubtedly, primary evacuation is mandatory; fibrinolytics are reserved as second-line treatment, also can be considered in coagulated hemothorax or patients who are at a high risk of surgical complications. In order to diminish any morbidity it is advisable to perform a systematic diagnostic and therapeutic approach.

Keywords : hemothorax; coagulated hemothorax; thoracic trauma; treatment; pleural drainage; video-assisted thoracoscopic surgery.

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