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Longest delayed hemothorax reported after blunt chest injury
Darren Yap1, Miane Ng2, Madhu Chaudhury1
1Emergency Department, Royal Blackburn Hospital, Haslingden Rd, Blackburn BB2 3HH, United Kingdom.
The American Journal of Emergency Medicine
|October 29, 2017
Summary
Delayed hemothorax after blunt chest trauma is rare, with a case presenting 44 days post-injury. Emergency physicians must remain vigilant for this condition, even with delayed presentation, to ensure timely management and prevent complications.
Area of Science:
- Emergency Medicine
- Trauma Surgery
- Thoracic Surgery
Background:
- Blunt chest trauma is a frequent emergency department presentation.
- Delayed hemothorax, occurring weeks after initial trauma, is a rare but significant complication.
- This case highlights an unprecedented 44-day delay in hemothorax presentation post-blunt trauma.
Observation:
- A 52-year-old male presented with right-sided chest pain two weeks after a fall.
- Initial X-rays revealed rib fractures but no hemothorax.
- Forty-four days post-trauma, he returned with shortness of breath, revealing a large right hemothorax requiring drainage of 1850ml of blood.
Findings:
- The patient's hemothorax resolved within 48 hours of drainage.
- Complete recovery was achieved after a six-week follow-up.
Implications:
- Emergency physicians must maintain a high index of suspicion for delayed hemothorax following blunt chest injuries.
- Awareness of this rare condition is crucial for appropriate patient counseling, including warning signs and seeking prompt medical attention.
- Prompt diagnosis and management, including chest tube drainage, are vital for mitigating morbidity and mortality associated with delayed hemothorax.
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