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Hemothorax related to trauma.

¹Department of Thoracic and Cardiovascular Surgery, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390-8879, USA. dan.meyer@utsouthwestern.edu

Thoracic Surgery Clinics

|July 27, 2007

Summary

Most trauma-related hemothoraces are managed nonoperatively or with tube thoracostomy. Early thoracoscopic intervention for retained hemothorax can decrease hospital stay and costs, though some areas remain controversial.

Area of Science:

Trauma Surgery
Thoracic Surgery
Emergency Medicine

Background:

Hemothorax management in trauma is guided by established surgical principles.
Nonoperative approaches and tube thoracostomy suffice for most cases.
Operative intervention is reserved for a minority of patients.

Purpose of the Study:

To review current management strategies for traumatic hemothoraces.
To highlight the benefits of early thoracoscopic intervention for retained hemothorax.
To discuss controversial aspects of hemothorax management.

Main Methods:

Review of current literature on hemothorax management in trauma.
Analysis of nonoperative, tube thoracostomy, and operative interventions.
Evaluation of thoracoscopic techniques for retained hemothorax.

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Main Results:

Nonoperative management and tube thoracostomy are adequate for most traumatic hemothoraces.
Underlying organ damage can be more critical than hemothorax in blunt trauma.
Early thoracoscopic intervention for retained hemothorax reduces hospital stay and costs.

Conclusions:

Hemothorax management requires a tailored approach based on injury severity and type.
Thoracoscopic techniques offer advantages for retained hemothorax.
Areas such as prophylactic antibiotics and emergency thoracotomy require further clarification.