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Spontaneous hemopneumothorax: is conservative treatment enough?
G Haciibrahimoglu1, L Cansever, C I Kocaturk
1Yedikule Hospital for Chest Disease and Thoracic Surgery, Department of Thoracic Surgery, Istanbul, Turkey. ghaciibrahim@yahoo.com
The Thoracic and Cardiovascular Surgeon
|July 23, 2005
Summary
Spontaneous hemopneumothorax is a serious condition. Conservative treatment with chest tube drainage is effective for most patients with this rare disorder.
Area of Science:
- Thoracic Surgery
- Pulmonology
Background:
- Spontaneous hemopneumothorax is a rare but potentially life-threatening complication of spontaneous pneumothorax.
- It occurs in 1% to 12% of spontaneous pneumothorax cases.
Purpose of the Study:
- To highlight the critical nature of spontaneous hemopneumothorax.
- To re-evaluate the efficacy of conservative management, specifically chest tube drainage.
Main Methods:
- Retrospective review of 291 spontaneous pneumothorax cases treated between 1997 and 2002.
- Analysis of 9 cases (3.09%) that developed hemopneumothorax.
- Comparison of conservative and surgical treatment outcomes.
Main Results:
- Seven patients were managed conservatively; two required surgical intervention (VATS and thoracotomy) due to clinical deterioration.
- Blood aspiration volumes ranged from 400 to 3700 ml (mean 1533 ml).
- Six patients necessitated homologous blood transfusions.
Conclusions:
- Hemopneumothorax is a significant complication of spontaneous pneumothorax.
- Conservative management is generally adequate.
- Continue conservative treatment if bleeding resolves within 24 hours of chest tube insertion.