Spontaneous Hemopneumothorax: Analysis of 8 Cases

Abstract

Aim: Spontaneous hemopneumothorax is a rare disorder that results from a torn of small vessels located in adhesions between the visceral and parietal pleura resulting from the progress of lung collapse. A large spontaneous hemopneumothorax is often life threatening, and the late diagnosis and treatment can increase mortality rate. In this study; we present eight patients who presented to us with nontraumatic spontaneous hemopneumothorax and the clinical features of these patients and the results of conservative and surgical management were discussed. Material and Method: From January 2005 and September 2010, a total of 97 patients were treated with spontaneous pneumothorax. Eight (8.23%) developed spontaneous hemopneumothorax. We analyzed many factors such as sex and age distribution, affected site, the degree of lung kollaps, clinical symptoms, bleeding volume, etiology, treatments, complications. Result: Six patients (75 %) were male and 2 patients (25 %) were female and their mean age was 30.25 +/- 15.75 years. Hemopneumothorax is detected at the right side in 5 patients (62.5%), and at the left side in 3 patients (37.5%). The most common symptoms (62.5%) in all patients were chest pain and dyspnea. All patients were treated with the tube thoracostomy; five (62.5%) were treated with only the tube thoracostomy, and the other 3 (37.5%) were treated by the thoracostomy combined with video-assisted thoracic surgery. The amount of bleeding in patients who underwent video-assisted thoracic surgery ranged 1083.33 +/- 304.972 ml. The amount of bleeding in patients who underwent tube thoracostomy ranged 448.2 +/- 242.572 ml. Discussion: Closed-tube thoracostomy is the first choice in the cases of spontaneous hemothorax. Regular hemodynamic monitoring is needed in the cases with tube thoracostomy. When tube thoracostomy is not sufficient, VATS can be the first surgical treatment choice and thoracotomy may not be needed. Complete recovery may be expected with early diagnosis and proper treatment.