, pleural , mediastinal, and sometimes lung parenchymal vessels enters
the pleural cavity. Depending on the amount of bleeding and the underlying
cause, hemothorax may be associated with varying degrees of lung
collapse and mediastinal shift. Pneumothorax (air in the pleural cavity)
commonly accompanies hemothorax.
Cause: Usually results from blunt or penetrating chest
trauma. Hemothorax may result from thoracic surgery, pulmonary infarction,
neoplasm, disecting thoracic aneurysm, or anticoagulant therapy.
Symptoms:
Percussion reveals dullness, and auscultation reveals decreased to absent
breath sounds over the affected side.
Chest pain
Tachypnea
Mild to severe dyspnea (difficulty breathing) may be present
If respiratory failure results, the patient may appear anxious, restless,
possibly stuporous, and cyanotic.
Marked blood loss produces hypotension and shock.
The affected side of the chest expands and stiffens, while the unaffected
side rises and falls with the patient’s gasping respirations
Treatment:
Goal: to stabilize the patient’s condition, stop the bleeding,
evacuate blood from the pleural space, and reexpand the underlying lung.
Mild hemothorax usually clears in 10 to 14 days, requiring only observation
for further bleeding.
In severe hemothorax, thoracentesis may be performed, (not only use
as a diagnostic tool, but also as a method of removing fluid from the pleural
cavity.)
Chest tube
Suction may be used to prevent clot blockage
Thoracotomy may be done to evacuate blood and clots and to control bleeding.