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At least 19 recordsLinked to original sources

PubMed1995

[The effect of performance of diagnostic and therapeutic procedures on successful treatment of hemopneumothorax in isolated thoracic trauma].

Influence of performed diagnostic and therapeutic procedures on the outcome of the treatment of traumatic hemopneumothorax during isolated chest trauma. The aim of this study is the assessment of the influence of performed diagnostic and therapeutic procedures on the outcome of hemopneumothorax as a part of isolated chest trauma. The main group consists of 51 patients with hemopneumothorax. Patients with pneumothorax without effusion represent the first control group; the second control group consist of patients treated because of iatrogenic pneumothorax. In the main and control groups the analysis of clinical, roentgenographic and functional parameters was made, together with the analysis of particular therapeutic procedures, the estimation of the success of the treatment was based on roentgenographic and functional parameters. The higher incidence of hemopneumothorax compared with control groups during chest trauma in the analyzed material is statistically significant. The occurrence of bilateral hemopneumothorax in 10% of cases emphasizes the need of adequate roentgenographic assessment of injured patients. Regardless of the intensity of the trauma, symptoms do not always indicate the existence of hemopneumothorax. The number of fractured ribs is not of significant importance in terms of the occurrence of hemopneumothorax or pneumothorax. Severe dyspnea can be accompanied even with a smaller collapse of the lung independently of the amount of blood in the pleural cavity. Oxygenation in the arterial blood is impaired with the great and small pulmonary collapse. Hemodynamic disorders existed in 14% all cases. The higher frequency of operative treatment in the main group is statistically significant. The majority of cases of traumatic hemopneumothorax can be successfully treated by the conservative treatment. Accompanying complications do not have greater influence on the outcome.

Adult↗

PubMed1997

Hemopneumothorax missed by auscultation in penetrating chest injury.

OBJECTIVE: To determine the frequency and extent of hemothorax, pneumothorax, and hemopneumothorax missed by auscultation in penetrating chest injury. DESIGN: A retrospective chart and chest radiograph review. MATERIALS AND METHODS: One hundred and eighteen patients suffering penetrating chest injuries during 1993 were studied. A missed auscultation was defined as a patient with normal breath sounds but shown by chest radiograph to have a hemothorax, pneumothorax, or hemopneumothorax. The amount of hemothorax was recorded after chest tube placement or at thoracotomy. The degree of pneumothorax was determined by Rhea's method. RESULTS: Seventy-one patients (60%) had a hemothorax, pneumothorax, or hemopneumothorax. Auscultation to detect hemothorax, pneumothorax, or hemopneumothorax had a sensitivity of 58%, a specificity of 98%, and a positive predictive value of 98%. Thirty of 71 patients (42%) were found to have pleural space blood or air missed by auscultation. Twelve patients (41%) had a hemopneumothorax, 11 patients (36%) had hemothorax, and seven patients (23%) had pneumothorax. Auscultation missed hemothorax up to 600 mL, pneumothorax up to 28%, and hemopneumothorax up to 800 mL and 28%. CONCLUSION: Hemopneumothorax and hemothorax are the conditions most likely to be missed by auscultation, especially in patients with gunshot wounds. Auscultation has a high positive predictive value because it indicates injury with a fair degree of certainty; however, a negative auscultation does not rule out injury.

Adolescent↗

PubMed1990

[Four cases of spontaneous hemopneumothorax].

We reported four cases of spontaneous hemopneumothorax. Of these, one (a 25-year-old man) had right hemopneumothorax and three (a 28-year-old man, a 21-year-old woman and a 24-year-old man) had left hemopneumothorax. In one case, because massive intrapleural bleeding had continued, an emergency operation was performed. In two cases, thoracotomy was performed because of recurrent pneumothorax. In the other case, about one week after hemopneumothorax had been controlled by pleural drainage, pneumothorax recurred and thoracotomy was performed. In conclusion, early thoracotomy is the best treatment for spontaneous hemopneumothorax.

Adult↗

PubMed1998

Video-assisted thoracoscopic surgery for spontaneous hemopneumothorax.

We operated on 403 patients with spontaneous pneumothorax between 1992 and 1996. Among these cases, 11 (2.7%) were spontaneous hemopneumothorax. The patients were all men, with ages ranging from 19 to 28 years (mean 23.8 years). The amount of blood drainage ranged from 650 to 2300 ml. Video-assisted thoracoscopic surgery was performed on these patients within 1 day after admission. The sources of bleeding were in the parietal and visceral pleurae of ruptured bullae (n = 6), the parietal pleura (n = 4), or the visceral pleura (n = 1). During operation, the ruptured bullae can be managed by an endoscopic linear stapler for a bullectomy, and the bleeding parietal pleura of the torn adhesion can be coagulated directly. Postoperative recovery of the 11 patients was uneventful, and they were discharged 4 to 10 days after the operation. No recurrence of spontaneous hemopneumothorax or any other complications occurred during follow-up. Thus spontaneous hemopneumothorax can be readily managed by cauterizing a bleeding site where appropriate, excising the apicocystic disease, and pleurodesis. As a minimally invasive method, video-assisted thoracoscopic surgery may be considered an initial treatment procedure in patients with spontaneous hemopneumothorax.

Adult↗

PubMed1998

[Video-assisted thoracoscopic surgery in spontaneous hemopneumothorax].

We retrospectively studied the safety and utility of video-assisted thoracoscopic surgery (VATS) in the treatment of spontaneous hemopneumothorax. Of 128 cases of spontaneous pneumothorax operated on our hospital from April 1988 to October 1997, hemopneumothorax developed in 8 cases (2 cases treated by thoracotomy and 6 by VATS). In all 8 cases, bleeding points and pulmonary bullae were easily found and hemostasis and resection of pulmonary bullae conducted quickly and safely. Two cases of VATS involved elective surgery. Of surgical emergent cases, the duration from visit our hospital to operation and surgical duration in VATS were almost as long as those in thoracotomy. The mean duration of postoperative chest drainage and postoperative hospital stay in VAST were less than in thoracotomy except for a VAST case with persistent air leakage. Blood loss from onset to operation and blood transfusion for VATS were almost equal to thoracotomy. Postoperative duration of analgesic use for VATS were shorter than that for thoracotomy. The VATS case with persistent air leakage should be necessary to reinforce the pulmonary stapled line or to convert to thoracotomy. In all cases, residual hematoma was found in the thoracic cavity. We conclude that early surgical repair should be performed once spontaneous hemopneumothorax is diagnosed and confirmed, and that VATS may be the first choice of surgery because it provides a better view and more facilitated manipulation during surgery than thoracotomy, and is a safe, nonaggressive therapeutic option.

Adult↗

PubMed2002

Thoracoscopic treatment for spontaneous hemopneumothorax.

Spontaneous hemopneumothorax is a rare clinical entity sometimes requiring an operation in the early stage. Two patients who underwent successful video-assisted thoracic surgery (VATS) for spontaneous hemopneumothorax are presented. In both cases, the bleeding point was clearly identified, and hemostasis was easily obtained by clipping the point and placing three access ports in the usual fashion. Furthermore, the evacuation of clotted blood and resection of bulla were performed with no difficulties. The postoperative courses were smooth, and no complications occurred, although the preoperative general condition in the second case was hemodynamically unstable. The advantages of VATS over conventional thoracotomy include less time required to access the pleural cavity, a better view, and more facilitated manipulation during surgery. Because spontaneous hemopneumothorax is a benign disease, VATS should be considered an initial treatment option in all patients with this condition, even those with active bleeding.

Adult↗

PubMed1996

Spontaneous hemopneumothorax.

BACKGROUND: Spontaneous hemopneumothorax is a rare disorder, occurring in 1% to 12% of patients with spontaneous pneumothorax. We studied our previously treated patients to determine the nature of optimal operative management. METHODS: This was a retrospective case study. From 1987 to 1994, of 428 cases of spontaneous pneumothorax that occurred in 234 patients treated at our institution, hemopneumothorax developed in 10 patients (2.3%). The clinical features of these patients were studied. RESULTS: The amount of bleeding ranged from 600 to 1,600 mL, and 3 patients exhibited symptoms of shock, such as sweating, nausea, and syncope. Six patients underwent operation within 7 days from the onset, and this involved resection of the bullae or pneumorrhaphy, or both. The source of bleeding was identified in 5 patients. Pathologic examination showed marked fibrosis with alcian blue-positive deposits of aberrant vessels. All 6 patients continue to be well postoperatively without recurrence or complications. Four patients did not undergo early thoracotomy. However, decortication was required in 3 of these patients because of a reactive fluid collection in the pleural space, which led to impaired lung expansion. CONCLUSIONS: Early surgical repair should be considered once diagnosis of a spontaneous hemopneumothorax is confirmed, because this provides better long-term results. Video-assisted thoracoscopic surgery as well as minithoracotomy should be considered as surgical options because of the improved quality of life they confer.

Adolescent↗

PubMed2003

Spontaneous hemopneumothorax: an overlooked life-threatening condition.

Spontaneous hemopneumothorax is a rare clinical entity. A large spontaneous hemopneumothorax is life-threatening, and mortality increases with delayed recognition and intervention. The initial chest radiography and the amount of blood drained from the inserted chest tube frequently underestimates the actual blood loss from the active bleeder around the ruptured apical bullae, leading to failed recognition of a potentially life-threatening condition until unexpected hemodynamic collapse develops. We report 2 cases of spontaneous hemopneumothorax to emphasize the importance of early recognition and prompt surgical intervention by video-assisted thoracoscopic surgery (VATS).

Adult↗

PubMed2000

Spontaneous hemopneumothorax--results of conservative treatment.

Spontaneous hemopneumothorax is a serious condition complicating spontaneous pneumothorax. Early stage thoracotomy has been advocated to stop the bleeding and evacuate the coagulated blood from the pleural cavity. The present review was undertaken to emphasize the potential life-threatening condition of spontaneous hemopneumothorax and reassess the benefit of conservative treatment with chest tube drainage. Out of six patients, five patients were treated conservatively and one required an emergency thoracotomy because of cardiovascular collapse. Although three patients still had minimal residual hemopneumothorax on discharge, none of them developed empyema or trapped lung. In conclusion, conservative treatment is efficient and should be performed if bleeding persists for less than 24 hours after chest tube placement.

Adult↗

PubMed1990

Loculated hemopneumothorax of a major fissure in patients with COPD and associated pleural disease.

Two patients with underlying COPD and bullous changes of the lungs were found to have a loculated hemopneumothorax within a major fissure by computed tomography. Both patients had associated pleural disease. In one of the patients, the hemopneumothorax was believed to be potentially compromising pulmonary function. Percutaneous needle drainage of the loculated hemopneumothoraces resulted in large symptomatic pneumothoraces requiring urgent insertion of closed thoracostomy tubes. Loculated hemopneumothorax is an unusual finding within a major fissure mimicking pulmonary abscess, infected bullae, pulmonary cyst, or a cavitary carcinoma of the lung. Physicians treating patients with COPD and associated pleural disease should be aware of this rare condition, since percutaneous needle drainage may be associated with serious life-threatening complications.

Hemopneumothorax↗

PubMed2000

Spontaneous hemopneumothorax in women.

Spontaneous hemopneumothorax is uncommon, especially among women. We report a case of spontaneous hemopneumothorax in a 19-year-old woman and review seven other cases of spontaneous hemopneumothorax in women that have been reported in the English language.

Adult↗

PubMedDate not supplied

Hemopneumothorax due to pulmonary metastasis with malignant hemangioendothelioma: CT and pathological findings.

Malignant hemangioendothelioma is a rare vascular tumor. The disease frequently recurs and eventually metastasizes to the lung in most cases. Hemopneumothorax developing soon after metastasis to the lung indicates on unfavorable prognosis. We had an opportunity to examine a patient who had malignant hemangioendothelioma in the occipital scalp and developed hemopneumothorax following metastasis to the lung. We report the computed tomographic (CT) and pathological finding in the patient, and review the literature on hemopneumothorax.

Adult↗

PubMed1995

[Treatment and etiology of spontaneous hemopneumothorax].

The incidence of spontaneous hemopneumothorax is reported to be 1-12% of all cases of spontaneous pneumothorax. We treated 152 cases of spontaneous pneumothorax in the past 8 years and hemopneumothorax occurred in 4 cases which is 2.6% of all cases of spontaneous pneumothorax. All the patients were male and the age ranged from 17 to 30. The total amount of blood loss ranged from 1,200-3,200 mliters and surgical treatment was carried out within 2 days after admission. The bleeding point was visceral pleura of raptured bulla in 2 cases, parietal pleura of the torn adhesion in 1 case, and both visceral and parietal pleura in 1 case. Postoperative course was satisfactory and discharged within 2 weeks after admission in all cases. The authors concluded that early thoracotomy is recommended for spontaneous hemopneumothorax.

Adolescent↗

PubMed1994

[11 operated cases of spontaneous hemopneumothorax].

UNLABELLED: During the period 1984-1993, we experienced 11 operated cases of spontaneous hemopneumothorax, which correspond 7.3% of total 150 cases of operated spontaneous pneumothorax. All cases were male, 19-36 years of age. From admission to the end of operation, 6 cases with hemorrhagic shock had bleeding of 2,305-6,670 ml, the average 3,708 ml, whereas 5 cases without shock had bleeding of 1,209-2,405 ml, the average 1,979 ml. In 9 cases operated within 5 days after admission (6 cases with shock and 3 cases without shock), the source of bleeding was detected, but in 2 cases operated over 6 days after admission, the source was not detected. For the emergency operation of hemopneumothorax, we employed axillary thoracotomy by half lateral position in order to avoid the blood pressure depression due to position changing of the patient. The operation performed safely with enough exposure, and all the patients recovered without severe complication. CONCLUSION: the treatment of spontaneous hemopneumothorax is better to choose early operation by axillary thoracotomy with half lateral position.

Adult↗

PubMed2000

Hemopneumothorax and hemoperitoneum in a case with large cell carcinoma of the lung.

Hemopneumothorax and hemoperitoneum coincide rarely in nontraumatic cases. Here, a 70-year-old male presented a left axillary lymph node and was diagnosed as having metastatic squamous cell carcinoma. Under the same diagnosis, another lesion developed in the right femur and was resected. One year later, computed tomography detected another tumor in the left adrenal gland. Shortly afterwards, left pneumothorax developed and a chest operation revealed hemopneumothorax due to a ruptured cavitary form of large cell carcinoma. The serum showed a human chorionic gonadotropin-beta level of 1,100 ng/ml. At three-months later, he died of hemoperitoneum. The autopsy demonstrated hepatic metastases and a ruptured adrenal metastasis; microscopy showed marked trophoblastic and squamous cell changes in these organs. This patient was unique in that the rupture of the pulmonary and the adrenal lesions caused clinical manifestation.

Aged↗

PubMed2002

Spontaneous hemopneumothorax.

Spontaneous hemopneumothorax is a potentially fatal condition associated with 1-12% of all spontaneous pneumothoraces. Prompt diagnosis is essential in order to allow for rapid surgical intervention. A case of a 15-year-old male with spontaneous hemopneumothorax diagnosed by CT is presented. The patient recovered after surgery with no complications.

Adolescent↗

PubMed1975

Hemopneumothorax following blunt trauma of the thorax.

Hemopneumothorax is a frequent sequel of blunt trauma of the thorax and is easily treated if it occurs without associated injury. As an isolated injury, it is accompanied by a low mortality rate, 2 per cent in this series of 330 patients. The principal treatment for hemopneumothorax was tube thoracostomy with large bore chest tubes. Initial thoracotomy was required for 3.3 per cent of the patients, and late thoracotomy for complications was necessary only in 1.2 per cent of the patients. The over-all mortality rate of 20.3 per cent reflected the many associated injuries. Extrathoracic trauma played a significant role in 44 of the 67 deaths.

Adolescent↗

PubMed2001

[Three cases of emergency video-assisted thoracoscopic surgery for spontaneous hemopneumothorax].

We experienced 3 cases of video-assisted thoracoscopic surgery for spontaneous hemopneumothorax. All the patients had received emergent operations because of massive intrathoracic bleeding. At the operation, a 3 cm-minithoracotomy and 2 trocar ports were fashioned. In the head up position, massive blood clots in the apex in the thoracic cavity was removed by using grasping forceps and the source of bleeding point was detected easily. The bleeding was successfully stopped. It was difficult to remove massive blood clots from trocar port by suction, however it was easy to remove massive blood clots from a 3 cm-minithoracotomy window by using a large grasping forceps. Post operative course was satisfactory and the all patients discharged within 2 weeks after admission. We concluded that the spontaneous hemopneumothorax may be a good indication for video-assisted thoracoscopic surgery.

Adolescent↗