Isolated hemothorax following thoracic trauma: analysis of 57 cases

Abstract

AimThe aim of this study was to review cases with isolated hemothorax after thoracic trauma, to assess the diagnostic and treatment methods, and to discuss the determining factors of morbidity and mortality.MethodsA total of 57 patients were examined retrospectively. All patients underwent tube thoracostomy and underwater seal as the initial treatment approach. Emergency thoracotomy was performed on cases with continuing drainage from the chest tube, expanding hemothorax on the posteroanterior (PA) chest x-ray, and with hemodynamic instability.ResultsHemothorax oc-curred as a result of penetrating trauma in 31 (54.38%) and due to blunt trauma in 26 (45.61%) cases. Of the cases, 49 (85.96%) underwent tube thoracostomy drainage. All the 8 cases (14.03%) that underwent emergen-cy thoracotomy had penetrating trauma. Mortality occurred in one patient (1.75%) who had penetrating trauma and who underwent emergency thora-cotomy. The morbidity rate in patients with blunt trauma was significantly higher than those with penetrating trauma (P < 0.0001). ConclusionAccurate diagnosis and appropriate surgical intervention in cases with traumatic he-mothorax is essential for reducing the morbidity and mortality. Chest tube insertion and underwater seal application should be the initial treatment mo-dality and successful in most cases. Emergency thoracotomy is life-saving in indicated patients. The need for thoracotomy is higher in isolated hemo-thorax due to penetrating chest trauma.

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