I. See Also

II. Causes: Chest Traumatic injury

  1. Lung Laceration
  2. Intercostal artery vessel injury
  3. Internal mammary vessel injury
  4. Thoracic Vertebral Fracture

III. Management: Small Hemothorax (<300 cc)

  1. Size cutoff for small Hemothorax: 300 cc
    1. Dubose (2012) Trauma Acute Care 72(1): 11-22 [PubMed] (or open in [QxMD Read])
  2. Evaluation by CT Chest
    1. XRay is inadequate to estimate Hemothorax size
  3. Calculation
    1. Estimate area of Hemothorax on an individual CT slice
    2. Multiply by the CT slice thickness
    3. Mulitply by the number of slices in which the Hemothorax appears
  4. Indications for standard Chest Tube drainage of small Hemothorax
    1. Symptomatic patient
    2. Subacute Hemothorax (cut-off for drainage is lower than standard 300 cc cutoff)
    3. Suspected superinfection of Hemothorax (empyema)
  5. Indications for small Pigtail Chest Catheter (8-16 french)
    1. Consider for a borderline size Hemothorax in an otherwise well patient
  6. Indications for observation of small Hemothorax
    1. Healthy asymptomatic patient
  7. Complications of an undrained small Hemothorax (uncommon)
    1. Retained Hemothorax
    2. Empyema (superinfected Hemothorax)
    3. Fibrothorax (lung trapped in Hemothorax)
  8. References
    1. Inaba in Majoewsky (2012) EM:Rap 12(11): 1

IV. Management: Massive Hemothorax

  1. Consider autotransfusion device (e.g. hemovac, cell saver)
  2. Large bore Chest Tube (36-40 french) at the 5th intercostal space in the midaxillary line

V. Precautions: Indications for operative management

  1. Chest Tube output >1500-2000 cc total or
  2. Chest Tube output 150-200 cc/hour for several hours

VI. References

  1. (2012) ATLS 9th ed, American College of Surgeons, Committee on Trauma, p. 96-9

Images: Related links to external sites (from Google)

Ontology: Traumatic hemothorax (C0340006)

Concepts Injury or Poisoning (T037)
ICD10 S27.1
SnomedCT 157331005, 210048005, 42458003, 157329001, 269340000
English Traumatic haemothorax, NOS, Traumatic hemothorax, NOS, traumatic hemothorax (diagnosis), traumatic hemothorax, Traumatic haemothorax (disorder), Traumatic haemothorax, Traumatic hemothorax, Traumatic hemothorax (disorder), hemothorax; traumatic, traumatic; hemothorax, Haemothorax - traumatic, Hemothorax - traumatic
Spanish Hemothorax - traumatic, Traumatic hemothorax, Traumatic haemothorax, Haemothorax - traumatic, hemotórax traumático (trastorno), hemotórax traumático
German Traumatischer Haematothorax
Korean 외상성 혈액가슴증
Dutch hemothorax; traumatisch, traumatisch; hemothorax, Traumatische hemothorax

Ontology: Traumatic pneumohemothorax (C0340008)

Concepts Injury or Poisoning (T037)
ICD9 860
ICD10 S27.2
SnomedCT 157332003, 210049002, 233643006, 210050002, 42434002
English Traum.pneumo/haemo-thorax NOS, Traumatic haemopneumothorax, NOS, Traumatic hemopneumothorax, NOS, Traumatic pneumo/haemo-thorax, Traumatic pneumohaemothorax, NOS, Traumatic pneumohemothorax, NOS, Traumatic pneumothorax and haemothorax NOS, Traumatic pneumothorax and hemothorax NOS, Traumatic haemopneumothorax (disorder), Traumatic pneumothorax and hemothorax NOS (disorder), Traumatic pneumothorax and hemothorax, Traumatic haemopneumothorax, Traumatic hemopneumothorax, Traumatic pneumothorax and haemothorax, Traumatic pneumohaemothorax, Traumatic pneumohemothorax, Traumatic pneumohemothorax (disorder), hemopneumothorax; traumatic, hemothorax; traumatic, with pneumothorax, pneumohemothorax; traumatic, pneumothorax; traumatic, with hemothorax, traumatic; hemopneumothorax, traumatic; hemothorax, with pneumothorax, traumatic; pneumohemothorax, traumatic; pneumothorax, with hemothorax
Spanish Traumatic hemopneumothorax, Traumatic haemopneumothorax, Neumohemotórax traumático, Neumohemotorax traumático, Neumotórax y hemotórax traumáticos, hemoneumotórax traumático (trastorno), hemoneumotórax traumático, neumohemotórax traumático, neumotórax y hemotórax traumáticos, SAI (trastorno), neumotórax y hemotórax traumáticos, SAI
French Pneumothorax et hémothorax traumatiques, Pneumohémothorax traumatique
Dutch traumatische pneumothorax en hemothorax, traumatische pneumohemothorax, hemopneumothorax; traumatisch, hemothorax; traumatisch, met pneumothorax, pneumohemothorax; traumatisch, pneumothorax; traumatisch, met hemothorax, traumatisch; hemopneumothorax, traumatisch; hemothorax, met pneumothorax, traumatisch; pneumohemothorax, traumatisch; pneumothorax, met hemothorax, Traumatische hemopneumothorax
Portuguese Pneumemotórax traumático, Pneumotórax e hemotórax traumático
German traumatischer Pneumohaemothorax, traumatischer Pneumothorax und Haemothorax, Traumatischer Haematopneumothorax
Italian Pneumotorace ed emotorace traumatici, Pneumoemotorace traumatico, Emotorace e pneumotorace traumatico
Japanese ガイショウセイキケツキョウ, ガイショウセイキケッキョウ, 外傷性気血胸
Czech Traumatický pneumotorax a hemotorax, Traumatický pneumohemotorax
Korean 외상성 혈액공기가슴증
Hungarian Traumás pneumothorax és haemothorax, Traumás pneumohaemothorax