• Title/Summary/Keyword: Hemothorax

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Quantitative analysis of hemothorax by computed tomography (흉부 전산화 단층촬영을 이용한 혈흉의 정량분석)

  • 강청희
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.228-232
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    • 1995
  • Computed tomography[CT is an effective technique for the evaluation of the thorax following blunt trauma. To evaluate multiply injured 30 patients who were diagnosed as hemothorax in emergency room, computed tomography of thorax was done. The thickness of slice was one centimeter and the entire pleural cavity from the apex to the costophrenic angle was included in the evaluation. Integration and addition of the hemothorax area for each CT slice was made and amount of blood in the pleural cavity was estimated. The slice which showed largest area of hemothorax was selected and the height and width of the hemothorax area were measured. The number of slices which showed radiographic evidence of hemothorax was counted. Regression analysis was done and measured amount of hemothorax, the height and width of the hemothorax area for each slice and number of slices were put as variables. And following equation was derived. V=108.3A-0.8B-7.4C+84.7 [R2=0.74 [ V: amount of hemothorax, A: height, B: width, C: number of slices Total amount of blood from thoracic drainage was compared to the measured amount by computed tomography and the relation between the two values was statistically significant.[p=0.001 In conclusion, quantitative estimation of size of hemothorax was possible by the above equation and the process was very helpful for determination policy of treatment of individual patient.

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Influence of Multiple Rib Fracture upon Traumatic Hemo-pneumothorax (다발성 늑골골절의 외상성 혈기흉 발생에 대한 영향)

  • Yang, Seung-Joon;Lee, Je-won;Jin, Sang-Chan;Joo, Myeong-Don;Choi, Woo-Ik
    • Journal of Trauma and Injury
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    • v.21 no.2
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    • pp.91-99
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    • 2008
  • Purpose: Multiple rib fracture (MRF) and a hemopneumothorax accompany with most blunt chest traumas. We aimed to analyze the factors increasing the probability of a hemopneumothorax. In addition, other injuries accompanying MRF were analyzed. Methods: We retrospectively reviewed the medical records of 154 mutiple rib fracture patients who visited our hospital between January 2005 and December 2007. The medical records were reviewed for sex, age, mechanism of injury, location, number of fractures, distance of dislocated rib fragments, and presence of complications. We measured the distance of bony dislocations by using the PACS (Picture Archiving and Communication System). Results: The average number of rib fractures was $3.7{\pm}2.1$, and the number of rib fractures significantly influenced the incidence of a hemothorax (p<0.001). The risk of a hemothorax was increased in a bilateral MRF compared to a unilateral MRF (p=0.027). The distance of dislocated rib fragments influenced the probability of a hemothorax significantly (p=0.018), and subcutaneous emphysema and lung contusion were significantly associated with a pneumothorax (p=0.021, p=0.036). Conclusion: The number of MRFs did not influence the risk for a pneumothorax, but did influence the risk for a hemothorax. The laterality, distance of dislocation, also had an influence on the risk for a hemothorax. Also, subcutaneous emphysema and lung contusion were increased in cases with a pneumothorax. We must consider the possibility of a hemothorax even when the initial chest X-ray shows no evidence of a hemothorax. If a lung contusion is present, then an occult pneumothorax must be considered.

Delayed Diaphragmatic Injury with Massive Hemothorax Due to Lower Rib Fracture (하부늑골 골절에 의한 지연성 대량혈흉을 동반한 횡격막 손상)

  • Kim, Woo-Shik;Kim, Joong-Suck
    • Journal of Trauma and Injury
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    • v.28 no.2
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    • pp.79-82
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    • 2015
  • Simple rib fracture is one of most common injury after blunt thoracic trauma found in approximately 7% to 40% of cases. Delayed traumatic diaphragmatic injury with massive hemothorax after rib fracture is rare but a potentially life-threatening condition. We present a rare case of a 79-year-old male with delayed diaphragmatic injury with massive hemothorax due to fracture of the lower ribs. Under thoracoscopy, hemothorax was evacuated, diaphragmatic rupture was identified and repaired, and the lower ribs were fixed with metal plate (s). Although simple lower rib fractures may be the only clinical finding, close observation and monitoring are required because of the possibility of diaphragmatic and/or intraabdominal organ injury.

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A Case of Pleural Endometriosis Presented as Right Sided Hemothorax in a Patient Who Underwent Kidney Transplantation (신장이식 후 우측 혈흉으로 발현한 흉막자궁내막증 1예)

  • Shin, Eun-Hye;Shin, Bo-Mi;Ha, Yeon-Jung;Jang, Il-Young;Jung, Ji-Won;Cho, Hyung-Jin;Park, Su-Kil
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.145-148
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    • 2013
  • Thoracic endometriosis is an uncommon disease that has four main forms: catamenial pneumothorax, hemothorax, hemoptysis, and pulmonary nodules. Since the growth of endometrial tissue depends on the presence of estrogen, thoracic endometriosis usually occurs in menstruating women between 25 and 35 years of age. Menstrual disturbances are common in women with chronic kidney disease (CKD). However, they could be reversed after kidney transplantation. Therefore, previously asymptomatic endometriosis may become symptomatic after kidney transplantation. A 49-year-old woman with CKD underwent kidney transplantation. A month later, she experienced dyspnea, and hemothorax in her right hemithorax. However, there was no evidence of infectious diseases and malignancy in thoracentesis, pleural biopsy, and computed chest tomography (CT). The serum and pleural fluid levels of his carbohydrate antigen 125 were elevated. Hemothorax secondary to pleural endometriosis was suspected. We tried hormonal therapy, and the hemothorax disappeared. At the sixth-month follow-up, there was no recurrence of hemothorax.

Hemothorax after Central Venous Catherization Failure through the Subclavian Vein (쇄골하정맥을 통하여 중심정맥도관 삽입 실패 후 나타난 혈흉 1예)

  • Kim, Dae-Young;Kim, Dae-Woo;Son, Hee-Won;Park, Sang-Jin;Lee, Deok-Hee
    • Journal of Yeungnam Medical Science
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    • v.25 no.2
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    • pp.175-181
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    • 2008
  • Central venous catheterization via an internal jugular vein or subclavian vein has become a common procedure in monitoring CVP and managing severely ill patients. However, there have beennumerous reports of complications associated with central venous catheterization. These include vessel injury, pneumothorax, hemothorax, nerve injury, arrhythmias, arteriovenous thrombosis, pulmonary embolism, and infection at the insertion site. We report a case of hemothorax after subclavian vein catheterization failure, along with successful treatment.

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Traumatic Extrapleural Hematoma Mimicking Hemothorax

  • Choi, Yong Seon;Kim, Soon Jin;Ryu, Sang Woo;Kang, Seung Ku
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.202-205
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    • 2017
  • After blunt chest injuries, extrapleural hematoma may result in a collection of blood between the parietal pleura and the endothoracic fascia. Extrapleural hematoma is frequently misdiagnosed as hemothorax. Extrapleural fat sign, the inward displacement of strip of extrapleural fat on computed tomography, is typical radiological findings of extrapleural hematoma. We encountered a case of extrapleural hematoma with a presentation similar to hemothorax after blunt chest injury.

Intralobar Pulmonary Sequestration with Hemoptysis and Hemothorax (혈흉과 각혈을 동반한 내엽성 폐분리증)

  • Park, Jeong-Min;Oh, Bong-Suk
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.708-710
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    • 2007
  • A 60-year-old female entered the emergency unit with a chief complaint of hemoptysis. Based on the computer tomographic image analysis of the chest, the patient was diagnosed as having an intralobar pulmonary sequestration that accompanied a hemothorax, and the hemothorax was do to the rupture of a pseudocyst. Pulmonary lobectomy of the left lower lobe and primary closure of an aberrant artery were both performed as an emergency operation. After one week following the operation, the patient was discharged without any postoperative complications.

Massive hemothorax after central venous catheter insertion in a patient with multiple trauma

  • Park, Jeong Heon;Song, Jaegyok;Oh, Pyeong-wha
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.1
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    • pp.81-85
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    • 2021
  • Central venous catheter (CVC) insertion is commonly used in the operating room and intensive care unit to monitor central venous pressure and secure an intravenous route to deliver medications and nutritional support that cannot be safely infused into peripheral veins. However, CVC insertion may be associated with serious complications such as arterial puncture, hematoma, pneumothorax, hemothorax, catheter infections, and thrombosis. Several methods have been recommended to prevent these complications. Here we report a case of massive hemothorax caused by attempts of CVC insertion into the internal jugular vein and subclavian vein in a patient with multiple trauma. CVC placement should be performed or supervised by an experienced physician to decrease the incidence of CVC-related complications. CVC insertion under ultrasound guidance is recommended.

A Case of Spontaneous Hemothorax with a Ruptured Variceal Phrenic Vein

  • Juhyun, Lee;Sung Kwang, Lee;Jinhong, Wi;Yoo Sang, Yoon;Il-Yong, Han;Yang Haeng, Lee
    • Journal of Chest Surgery
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    • v.55 no.6
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    • pp.482-484
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    • 2022
  • Spontaneous hemothorax is rare, with limited data available on its etiology and treatment. We report a case of massive spontaneous hemothorax with a ruptured variceal phrenic vein during pregnancy, likely a complication of the Kasai procedure. Despite closed thoracostomy, the patient's symptoms and imaging findings did not improve. Emergent open thoracotomy and bleeding control were performed.

Spontaneous Hemothorax in a Patient with Posterior Mediastinal Neurilemmoma -A case report- (자발성 혈흉을 동반한 후종격동 신경섬유초종)

  • 김혁;양주민;정기천;김영학;강정호;정원상
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.1019-1021
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    • 2004
  • Neurogenic tumors are common in posterior mediastinal tumors. In most cases, tumors were accidentally showed on simple chest X-ray. In some cases, they were presented by symptoms which were induced by nerve compression or airway compression. But as in our case, neurogenic tumor with spontaneous hemothorax is very rare. A 45-year-old man admitted to emergency room of other hospital because of acute right chest pain and dyspnea. A chest X-ray showed a right pleural effusion. Hemothorax was diagnosed after closed thoracostomy. Following chest CT showed posterior mediastinal mass. The patient was transferred to our hospital. T spine MRI showed dumbbell shaped mass. Diagostic impression was neurogenic tumor. The pathologic result was neurilemmoma after surgical resection.