Hemothorax

Hemothorax Definition

It is a condition that results from accumulation of blood in the pleural cavity, the space between the lung and the chest wall.

Hemothorax Causes

Chest trauma is the most common cause of this ailment. It may also arise in individuals suffering from problems like:

  • Tuberculosis
  • Pulmonary Infarction or death of lung tissue
  • A defect of blood coagulation (clotting)
  • Thoracic or heart surgery
  • Pleural cancer (cancerous condition of the Pleura, the membranous sacs covering the lungs)
  • Pulmonary embolism (an ailment in which a blood clot gets lodged in a blood vessel present in the lungs)
  • Lung cancer
  • Positioning of a central venous catheter
  • Pneumothorax or collapsed lung
  • Injury to the chest wall or the intrathoracic structures

Blunt and penetrating trauma to the chest is the most common causative factor behind Hemothorax. Blunt trauma can be caused due to contact sports injuries, car accidents and falls. Blunt Traumatic Hemothorax can lead to broken ribs that cut into lung tissue and result in bleeding. Penetrating trauma is usually caused by knife, gunshot or any other sharp objects. Penetrating trauma can slice into the lung tissue and result in bleeding and Hemothorax.

The problem can also arise from various medical conditions such as bleeding disorders. Complications after performing medical procedures, such as heart surgery and chest surgery (thoracic surgery) also often lead to Hemothorax. The ailment may also result as a side-effect of blood-thinning medications and anticoagulants.

Hemothorax Symptoms

Patients with this condition typically suffer from severe respiratory difficulties. In cases of a lung collapse, they may also experience an unusual heart rate. This is usually accompanied with paleness of skin and the mucosa around the mouth and eyes.

Some other typical Hemothorax signs and symptoms include

  • Anxiety
  • Restlessness
  • Shortness of breath
  • Tachycardia (rapid heart rate)
  • Cool and clammy skin
  • Low blood pressure
  • Loss of consciousness
  • Fatigue

The intensity of Hemothorax symptoms of varies depending on the causative factor as well as the volume of blood in the thoracic cavity. Very mild trauma can lead to minimal bleeding and may produce few symptoms or none. In contrast, excess Hemothorax can result in acute chest pain and shock.

Hemothorax Diagnosis

The diagnosis of this problem is generally done by noting a decrease or absence of breathing sounds on the impacted side. The symptoms of the condition are usually diagnosed with the aid of diagnostic tests like:

  • CT scan
  • Chest x-ray
  • Thoracentesis
  • Chest ultrasound
  • MRI scanning of the chest
  • Pleural fluid analysis
  • Complete blood count (CBC)
  • Pulse Oximetry

Some other tests that can be used to evaluate Hemothorax involve:

  • Sputum cytology – Cells from lung mucus are tested for cancer in this examination.
  • Bronchoscopy – A sample of tissue is obtained in this test to affirm the diagnosis.
  • Thoracentesis – A needle is used to take out fluid from within the chest cavity.
  • Telomerase – It involves a blood test to check for the presence of lung cancer.

Hemothorax Treatment

If a patient of this condition has a lung collapse, he or she may suffer from unusual heart rhythm along with paleness of the skin. Lack of timely medical care can result in death of the patient. Even in less acute cases of this condition, a number of complications may arise. These include

  • Empyema
  • Fibrosis or scarring of the pleural membranes
  • Pneumothorax
  • Shock
  • Death

Hemothorax arising along with Pneumothorax (lung collapse) can result in severe symptoms. All such cases can be critical. Immediate medical attention is required to tackle these problems.

The aim of treatment is to stop the bleeding and restore stability into the condition of the patient. This involves insertion of a tube into the chest wall to remove the air and blood in the pleural space. It is left in position for a few days for re-expansion of the lung. In cases of severe Hemothorax, chest tube is insufficient in controlling the bleeding. A Thoracotomy surgery may be required to stop the bleeding.

Treatment also involves treating the cause of the problem. Chest tube drainage is often enough to cure victims of an injury. Surgery is frequently found to be unnecessary.

Massive Hemothorax Definition

It is a severe form of Hemothorax that is common in people with both blunt and penetrating chest injuries. This usually results in blood accumulation inside the thoracic cavity instead of blood vessels. In acute cases, it may give rise to Cyanosis.

Tension Hemothorax

It is a complicated condition that results from a build-up of air in the thoracic cavity. It puts undue pressure on the heart and also results in lung collapse. The heart fails to pump blood effectively due to this condition.

Spontaneous Hemothorax

It is a rare, life-threatening complication of Neurofibromatosis, an inherited autosomal disorder that is characterized by many neurofibromas, skin spots and developmental abnormalities.

Hemothorax Vs Pneumothorax

Hemothorax is often confused with Pneumothorax, as both of them can be found in the pleural cavity (the cavity in the thorax that consists of the heart and lungs). These are two different conditions. A pneumothorax is the name given to a sac of air in the pleural cavity. A hemothorax refers to a sac filled with blood in the pleural cavity that may result as a side effect of tuberculosis treatment or due to a chest injury.

Catamenial Hemothorax

It is a particular condition that leads to the accumulation of blood even without lung collapse. It is an abnormal problem that is associated with Thoracic Endometriosis.

The prognosis of Hemothorax depends on the cause of the condition as well as the how quickly the treatment is given. If left untreated, the disorder can result in acute complications. If you are suffering from severe chest pain, dizziness or acute breathing difficulties call your local emergency number (like 911). Timely cure will help you avoid undue complications and make a swift recovery.

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