The Annals of Thoracic Surgery, Vol 26, 204-207, Copyright © 1978 by The Society of Thoracic Surgeons
Acute traumatic hemothorax
GL Griffith, EP Todd, RD McMillin, JV Zeok, ML Dillon, JR Utley and WO Griffen
Over the past 5 years, 107 patients have been evaluated for acute traumatic
hemothorax at the University of Kentucky Medical Center. Immediate tube
thoracostomy was performed on 90 patients for evacuation of blood and air.
Only 2 patients died. Thoracotomy was performed as part of the initial
therapy in 9 patients. Thoracotomy for continued hemorrhage from a
pulmonary parenchymal injury was required in 3 patients from the entire
group. Thoracentesis or observation was the initial therapy for limited
hemothorax in 8 stable patients. Three of these patients subsequently
required tube thoracostomy 2 to 23 days following injury due to expanding
effusions, and 1 patient required multiple thoracotomies for sepsis,
fibrothorax, and empyema. These observations indicate that early evacuation
of blood by means of a tube thoracostomy is essential to minimize morbidity
in acute traumatic hemothorax. If continuing hemorrhage after tube
thoracostomy occurs, there is a higher association of injury to additional
vital structures.