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Updated: Apr 7, 2026

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Spontaneous bilateral extrapleural hematoma: a case report.

Sheng-I Hu1, Shih-Chun Lee2, Hung Chang3

  • 1Division of Colon & Rectal Surgery, Tri-Service General Hospital, National Defense Medical Center, 325, Cheng-Kung Road 2nd Section, Taipei, 114, Taiwan. roger720922@msn.com.

Journal of Cardiothoracic Surgery
|July 15, 2015
PubMed
Summary

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Extrapleural hematoma (EPH), a rare condition, is linked to hemodialysis due to increased venous pressure. This case highlights spontaneous EPH in a hemodialysis patient, emphasizing conservative management.

Area of Science:

  • Thoracic Surgery
  • Nephrology
  • Radiology

Background:

  • Extrapleural hematoma (EPH) is a rare thoracic condition typically associated with chest trauma.
  • Computed tomography (CT) is the standard diagnostic tool for identifying EPH, showing characteristic fat displacement.
  • The link between hemodialysis and EPH has not been previously reported.

Observation:

  • This study presents a case of spontaneous unilateral EPH in a patient undergoing chronic hemodialysis.
  • The patient later developed bilateral EPH following video-assisted thoracoscopic surgery (VATS).

Findings:

  • Hemodialysis may contribute to EPH through increased venous pressure, potentially caused by arteriovenous fistula complications like stenosis or thrombosis.
  • Pleuritis with pleural layer fusion can lead to hematoma formation in the extrapleural space rather than the pleural space.

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  • Conservative management is suggested as a key treatment approach for EPH.

    • Implications:

    • This case expands the known associations of EPH to include hemodialysis.
    • Increased awareness of EPH in hemodialysis patients is crucial for timely diagnosis and management.
    • Further research is needed to elucidate the precise mechanisms linking hemodialysis to EPH.