Pulmonology Book



Aka: Hemothorax, Massive Hemothorax, Traumatic Pneumohemothorax, Traumatic hemothorax
  1. See Also
    1. Pneumothorax
  2. Causes: Chest Traumatic Injury
    1. Lung Laceration
    2. Intercostal artery vessel injury
    3. Internal mammary vessel injury
    4. Thoracic Vertebral Fracture
  3. Precautions
    1. Color of blood recovered from Hemothorax does not reliably differentiate arterial from venous source
  4. Management: Small Hemothorax (<300 cc)
    1. Size cutoff for small Hemothorax: 300 cc
      1. Dubose (2012) Trauma Acute Care 72(1): 11-22 [PubMed]
    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
  5. Management: Massive Hemothorax (>1500 ml or one third Blood Volume)
    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
    3. Operative management as below
  6. Precautions: Indications for operative management (thoracotomy)
    1. Chest Tube output >1500-2000 cc total or
    2. Chest Tube output 150-200 cc/hour for several hours or
    3. Refractory hemodynamic instability or
    4. Penetrating anterior Chest Trauma medial to the nipple line
  7. References
    1. (2012) ATLS 9th ed, American College of Surgeons, Committee on Trauma, p. 96-9

Traumatic hemothorax (C0340006)

Concepts Injury or Poisoning (T037)
ICD10 S27.1
SnomedCT 157331005, 210048005, 157329001, 269340000, 42458003
English traumatic hemothorax (diagnosis), traumatic hemothorax, Traumatic haemothorax (disorder), Haemothorax - traumatic, Hemothorax - traumatic, Traumatic haemothorax, Traumatic hemothorax, Traumatic hemothorax (disorder), hemothorax; traumatic, traumatic; hemothorax, Traumatic hemothorax, NOS
German Traumatischer Haematothorax, Traumatischer Haemothorax
Korean 외상성 혈액가슴증
Czech Traumatický hemotorax
Dutch traumatische hemothorax, hemothorax; traumatisch, traumatisch; hemothorax, Traumatische hemothorax
French Hémothorax traumatique
Hungarian Traumás haemothorax
Italian Emotorace traumatico
Japanese 外傷性血胸, ガイショウセイケッキョウ
Spanish Hemotórax traumático, hemotórax traumático (trastorno), hemotórax traumático
Portuguese Hemotórax traumático
Derived from the NIH UMLS (Unified Medical Language System)

Traumatic pneumohemothorax (C0340008)

Concepts Injury or Poisoning (T037)
ICD9 860
ICD10 S27.2
SnomedCT 210049002, 157332003, 210050002, 233643006, 42434002
English Traum.pneumo/haemo-thorax NOS, Traumatic pneumo/haemo-thorax, Traumatic pneumothorax and haemothorax NOS, Traumatic pneumothorax and hemothorax NOS, pneumohemothorax traumatic, traumatic pneumohemothorax, traumatic pneumohemothorax (diagnosis), 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, Traumatic hemopneumothorax, NOS, Traumatic pneumohaemothorax, NOS, Traumatic pneumohemothorax, NOS
German Traumatischer Haematopneumothorax, traumatischer Pneumothorax und Haemothorax, traumatischer Pneumohaemothorax
Korean 외상성 혈액공기가슴증
Spanish neumotórax y hemotórax traumáticos, SAI (trastorno), neumotórax y hemotórax traumáticos, SAI, Neumotórax y hemotórax traumáticos, Neumohemotórax traumático, Neumohemotorax traumático, hemoneumotórax traumático (trastorno), hemoneumotórax traumático, neumohemotórax traumático
Czech Traumatický pneumohemotorax, Traumatický pneumotorax a hemotorax
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
French Pneumohémothorax traumatique, Pneumothorax et hémothorax traumatiques
Hungarian Traumás pneumothorax és haemothorax, Traumás pneumohaemothorax
Italian Pneumotorace ed emotorace traumatici, Pneumoemotorace traumatico, Emotorace e pneumotorace traumatico
Japanese 外傷性気血胸, 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
Portuguese Pneumemotórax traumático, Pneumotórax e hemotórax traumático
Derived from the NIH UMLS (Unified Medical Language System)

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