Traumatic hemothorax: complications and management.
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The frequency of pleural complications was examined in 72 patients with recent fractures of the thoracic spine. 17 patients (24%) were found to have pleural hemorrhage. In 8 cases this was the result of isolated spinal fracture, without fracture of the ribs. In these cases, posterior mediastinal effusion, which was readily visible on chest films, always occurred prior to or concomitantly with the pleural effusion. Most of the spinal fractures were located between the fourth and eighth vertebrae. Bone lesions were always serious unstable fractures with vertebral collapse and kyphosis. Acute respiratory distress and/or cardiovascular collapse in a patient with thoracic spine injury should suggest pleural hemorrhage.
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This article reports the case of a patient who sustained an injury of the intercostal artery after a vena subclavia aspiration with extensive haemothorax. After thoracotomy, haemostatic treatment, respiratory therapy, intensive care and a prolonged hospital stay the female patient was discharged with a clean bill of health.
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