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PubMed2006

[Abundant hemothorax revealing extralobular pulmonary sequestration].

Hemothorax is an exceptional, serious and misleading manifestation of extralobular sequestration. We report the case of a 15-year-old patient who consulted for chest pain and sudden onset dyspnea. The chest x-ray revealed fluid pleural effusion. Pleural puncture produced a bloody fluid and the angioscan showed a hyperdense formation without a systemic artery. Thoracotomy was performed. A left intrapleural pyramidal formation vascularized with a pedicle from the thoracic aorta was identified and sequestrectomy performed. At two years, the patient has remained symptom free. Extralobular sequestration is an exceptional cause of hemothorax. The absence of an aberrant systemic vessel on the angioscan should not rule out the diagnosis of sequestration. Precautions must be taken at surgery to avoid vessel damage.

Adolescent↗
PubMed2003

Spontaneous hemothorax associated with von Recklinghausen's disease.

Spontaneous hemothorax is a rare and life threatening complication of neurofibromatosis. Two types of vascular involvement have been described: (a) stenotic or aneurysmal alterations in large vessels such as the aorta and its branches; and (b) dysplastic features in smaller vessels. Thoracotomy and surgical ligation of the bleeding vessels is primarily indicated in the presence of active bleeding with associated hemodynamic compromise. A more conservative approach with endovascular embolization or non-operative management have also been reported in case of hemodynamic stability. We present a rare case of spontaneous hemothorax treated conservatively in a patient with von Recklinghausen's disease.

Adult↗
PubMed2005

[Spontaneous hemothorax caused by lung cancer].

Spontaneous hemothorax is an extremely rare complication of malignant disease. We describe the case of a 26-year-old man with spontaneous hemothorax secondary to large-cell carcinoma of the lung, with liver and bone metastases. The patient died in the fifth week after hospitalization.

Adult↗
PubMed1992

Fatal hemothorax from mycotic celiac artery aneurysm.

We present two cases of ruptured mycotic aneurysms infected with Staphylococcus aureus. Each patient had hemoptysis and in each case there was hemothorax caused by a ruptured mycotic aneurysm of the celiac artery. In case 1, the pathogenesis was transient Staphylococcus aureus septicemia infecting an atherosclerotic plaque with subsequent aneurysm formation and rupture. In case 2, the septicemia arose from an infected knee. The presentation of a celiac artery aneurysm as hemoptysis and as the cause of hemothorax is rare.

Aged↗
PubMed1995

Effectiveness of chest tube clamping in massive hemothorax.

OBJECTIVE: To test the effectiveness of chest tube clamping in massive hemothorax. DESIGN, MATERIALS AND METHODS: This was assessed in 32 spontaneously breathing Yorkshire piglets with 2.5 mm (groups A and B) or 4.0 mm (groups C and D) lacerations of the thoracic aorta. MEASUREMENTS: Hemodynamics, blood loss, length of survival, and arterial blood gases (on 100% oxygen) were monitored. The four groups of eight animals all had chest tubes but groups A and C had these tubes clamped. Measurements were made at baseline, immediately after aortic injury, and every 15 minutes until death. RESULTS: Groups C and D survived 39 +/- 4 and 38 +/- 5 minutes respectively compared to 68 +/- 6 and 70 +/- 4 minutes in groups A and B. Total blood loss was not statistically significantly different among the four groups (1225 +/- 72, 1312 +/- 84, 1020 +/- 90, and 1110 +/- 84 mL for groups A, B, C, and D respectively). The rate of blood loss was greater in groups C and D (29.4 +/- 0.2 mL and 30.1 +/- 0.3 mL/min) compared with 14.7 +/- 0.5 mL and 16.0 +/- 0.9 mL/min respectively in groups A and B. Blood loss rate was similar with clamped or unclamped chest tubes. All groups had similar baseline cardiac output (3.5 to 3.8 L/min) and arterial blood pressures (110 to 114 mm Hg) with a greater decrease in these parameters following the larger lacerations and no difference with chest tube clamping. Arterial PO2 decreased from approximately 400 to 50 mm Hg with clamping but only decreased to approximately 350 mm Hg without clamping. The hypoxia was associated with significant hypercapnea (PCO2 of 78 mm Hg). CONCLUSIONS: Chest tube clamping did not decrease hemorrhage or mortality but worsened gas exchange without improving hypotension and is therefore not recommended in the treatment of massive hemothorax.

Animals↗
PubMed1985

Spontaneous hemothorax in a patient with Osler-Weber-Rendu disease.

We have reported a case of spontaneous hemothorax as a rare complication of Osler-Weber-Rendu disease (hereditary hemorrhagic telangiectasia). Because of the possibility of confusion with pulmonary infarction and its attendant treatment with anticoagulants, physicians should be aware of possible hemothorax in Osler-Weber-Rendu disease.

Arteriovenous Malformations↗
PubMed1994

Hemothorax due to hemorrhagic disease of the newborn.

A three day old male, term infant with hemothorax due to hemorrhagic disease of the newborn was treated successfully with vitamin K and thoracocentesis. Exclusive breast feeding and absence of vitamin K prophylaxis were important diagnostic clues, although hemothorax as a sole manifestation of hemorrhagic disease of the newborn is rare. This case highlighted the good prognosis of an uncommon complication when prompt diagnosis and appropriate treatment are instituted. The importance of vitamin K prophylaxis to all newborns is emphasized.

Drainage↗
PubMed1999

Bilateral hemothorax revealing mediastinal parathyroid adenoma.

We report the case of a 63-year-old woman admitted to hospital because of bilateral hemothorax associated with acute respiratory failure and laterotracheal neoformation. A right thoracoscopy biopsy revealed a paratracheal parathyroid adenoma which was responsible for bilateral hemothorax and primary hyperparathyroidism. A curative resection was successfully performed by cervicotomy.

Adenoma↗
PubMed1978

Hemothorax in a child. An unusual cause of chest pain.

The pediatrician should search carefully in a child with chest pain for evidence in the history or physical examination of an organic cause. Hemothorax is one of the pathologic processes that can present with this symptom. The differential diagnosis of hemothorax in children is reviewed.

Child↗
PubMed2005

Hemothorax as a complication after anterior cervical discectomy: case report.

OBJECTIVE AND IMPORTANCE: Anterior cervical discectomy is one of the most frequently performed surgical procedures of the cervical spine. CLINICAL PRESENTATION: We describe a patient with a postoperative hemothorax as a complication after an anterior cervical discectomy. INTERVENTION: The patient was intubated, and reoperation and bronchoscopy were performed. CONCLUSION: To the best of our knowledge, such a complication has not been described before in the English-language literature. We conclude that hemothorax is a rare, although serious, complication after anterior cervical discectomy and should be included in the differential diagnosis for patients with respiratory failure after an anterior cervical discectomy.

Blood Loss, Surgical↗
PubMed1988

Prehospital autotransfusion in life-threatening hemothorax.

Eighteen patients with life-threatening traumatic hemothorax received prehospital autotransfusion using a simple new device. During transfer to the hospital, they received 3.9 +/- 0.5 L of colloid fluid and 4.1 +/- 0.6 L of autotransfused blood, without anticoagulation. Hemorrhagic blood was not coagulable, had a hematocrit of 20 +/- 4 percent, few platelets, and low fibrinogen levels. Five patients died from irreversible hemorrhagic shock. Thirteen patients were alive upon admission to the hospital, underwent emergency surgery, and were discharged alive. During autotransfusion, hematocrit decreased from 24 +/- 3 to 19 +/- 3 percent, and systolic arterial pressure increased from 78 +/- 11 to 88 +/- 12 mm Hg. Upon admission to the hospital, platelet count was 90,800 +/- 21,400/cu mm, prothrombin time 48 +/- 3 percent, partial thromboplastin time 197 +/- 18 percent, plasma free hemoglobin levels 21 +/- 7 mg/100 ml, and serum potassium levels 3.6 +/- 0.5 mmol/L. No serious complication could be related to autotransfusion considered to be crucial to patients' survival. The preliminary results of this study suggest that autotransfusion might be developed in the prehospital setting since it appears simple and safe, and represents the only hope of survival for patients with life-threatening hemothorax.

Blood Transfusion, Autologous↗
PubMed1988

Mediastinal tumors presenting as spontaneous hemothorax, simulating aortic dissection.

The usual causes of hemomediastinum and hemothorax include chest trauma, rupture of an aortic aneurysm or aortic dissection. We report two patients who presented with a clinical picture of aortic dissection. In both patients, the chest radiograph revealed anterior mediastinal masses. Aortic dissection could not be excluded on the basis of the chest radiograph, and additional investigation by thoracic aortography was performed. The tumors had undergone spontaneous bleeding into the mediastinum and the pleural space, presumably causing the patients pain. The interesting and unusual causes of spontaneous hemomediastinum and hemothorax are reviewed.

Adult↗
PubMed1988

Massive hemothorax due to intrathoracic extramedullary hematopoiesis in a patient with thalassemia intermedia.

We report the case of a 49-year-old woman with thalassemia intermedia who developed a massive hemothorax due to hemorrhage from a large intrathoracic, paraspinal hematopoietic mass. Thoracotomy was required for initial control of bleeding. Postoperatively she received a total of 1,500 rads to the mass and has not had recurrence of the hemothorax. This complication of extramedullary hematopoiesis has not been previously reported, to our knowledge.

Female↗
PubMed1999

Spontaneous hemothorax secondary to immature teratoma of the mediastinum.

Spontaneous hemothorax in a 20-year-old boy was caused by rupture of an immature teratoma of the mediastinum. The tumor bled spontaneously into the right pleural space. This life-threatening complication necessitated emergency surgery. The unusual cause and the interesting clinical course of spontaneous hemothorax are described.

Adult↗
PubMed1999

Hepatocellular carcinoma with metastasis to the rib complicated by hemothorax. An autopsy case.

A 64-year old man was admitted to our hospital with multiple hepatocellular carcinoma (HCC) lesions in the liver, lung and bone. Three weeks after admission, the patient became complicated with right upper chest pain. A chest radiograph showed a marked increase in right pleural effusion. Thoracentesis demonstrated a hemothorax. Despite treatment with a continuous pleural tap and blood transfusions, the patient's clinical status worsened and he developed severe dyspnea. His right pleural effusion might be considered to be caused by a rupture of the HCC metastasis in the right 2nd rib. The patient died due to respiratory and hepatic failure 26 hours after his occurring the pleural effusion. An autopsy revealed moderately differentiated HCC in the liver, lung and bone. The HCC metastasis of the right 2nd rib was found to have torn the nearby pleura. We described a rare case in which hemothorax was caused by a ruptured rib-based HCC.

Bone Neoplasms↗
PubMed2002

Hemothorax and retroperitoneal hematoma after anticoagulation with enoxaparin.

A 58-year-old woman with chronic obstructive pulmonary disease had spontaneous bilateral hemothorax and a retroperitoneal hematoma after 4 days of anticoagulation therapy with enoxaparin (1 mg/kg subcutaneously every 12 hours) for suspected pulmonary thromboembolism. The patient was successfully managed with red blood cell and plasma transfusions, multiple thoracenteses for evacuation of blood from the pleural space, short-term mechanical ventilation, and administration of bronchodilators, corticosteroids, and antibiotics. This is the first report of spontaneous hemothorax and the third report of spontaneous retroperitoneal hematoma associated with enoxaparin therapy.

Anticoagulants↗
PubMed2002

[Acute contralateral hemothorax after cannulation of the left subclavian vein for hemodialysis].

Contralateral hemothorax after subclavian vein cannulation is a rare complication of this procedure. We report one case of acute contralateral hemothorax due to perforation of the superior vena cava during left subclavian vein cannulation for hemodialysis. Perforation was attributed to the forced insertion of the skin dilator, which was accidentally pushed too far. Chest pain began immediately after perforation and was followed, a few minutes later, by hemodynamic instability. The signs and symptoms described in this report may serve to warn of the possibility of this complication.

Acute Disease↗
PubMed2002

[Blood reflux through the catheter when trying catheterization of the subclavian vein is not a reliable sign in case of hemothorax].

A 36-year-old man suffered chest and neurovascular trauma, soft-tissue injury to the left arm, and trauma to facial bones and extremities. He was hemodynamically unstable and responded poorly to blood transfusion and vasoactive medication. Pneumothorax was suspected. When a tube was inserted into the left hemithorax, 1500 mL of blood was drained. A chest film revealed hemothorax and a contusion on the left lung, but no rib fractures. An attempt to catheterize the left subclavian vein yielded reflux, and blood was then transfused. The patient continued to be highly unstable and an additional 1000 mL of blood was drained. Exploratory thoracotomy revealed a ruptured subclavian vein, location of the venous catheter in the pleural cavity, and a fracture of the first left rib. After chest injury leading to hemothorax, reflux upon catheterization of the ipsilateral subclavian vein is not a sure sign of correct tip placement. Additional means for checking placement, such as assessing pressure wave morphology, should be used. A fracture of the first rib, which may not be evident on a chest x-ray, often causes a vascular lesion and thoracic hemorrhage. Incorrect insertion of a subclavian catheter may then follow.

Adult↗