• Journal of Chest Surgery
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• 제28권3호
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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.

• Journal of Trauma and Injury
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• 제21권2호
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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.

• Journal of Trauma and Injury
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• 제28권2호
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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.

• Journal of Yeungnam Medical Science
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• 제30권2호
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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.

• Journal of Yeungnam Medical Science
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• 제25권2호
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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.

• Journal of Trauma and Injury
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• 제30권4호
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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.

• Journal of Chest Surgery
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• 제40권10호
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• pp.708-710
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• 2007

60세 여자환자가 객혈을 주소로 응급실에 내원하였다. 환자는 내원 후 시행한 흉부 컴퓨터 촬영상 가성낭종의 파열로 인한 혈흉을 동반한 내엽성 폐분리증으로 진단되었다. 수술 시 좌하엽 절제술과 기형동맥 일차 봉합술을 시행하였고, 환자는 수술 후 1주일째 합병증 없이 퇴원하였다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권1호
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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.

• Journal of Chest Surgery
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• 제55권6호
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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.

• Journal of Chest Surgery
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• 제37권12호
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• pp.1019-1021
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• 2004

신경종은 후종격동 종양의 흔한 형태이며 주로 증상 없이 단순흉부촬영상 우연히 발견되거나 흉통이나 요통 등의 신경압박증상이나 기관지를 압박하여 나타나는 증상 등에 의해 발현되기 쉽다. 하지만 본 증례와 같이 자발성 혈흉을 일으키는 경우는 극히 드물다. 환자는 45세 남자로 갑자기 생긴 흉통 및 호흡곤란을 증상으로 타 병원 응급실 내원하여 시행한 단순흉부촬영상 우측 늑막삼출이 의심되어 폐쇄성 흉관삽입술 후 혈흉으로 진단되었고 흉부 전산화단층촬영상 후종격동 종양 소견 보여 본원으로 전원되었다. 전원 후 시행한 흉추 자기공명영상촬영상 아령모양의 신경종 의심되어 수술적 절제를 시행하였고 병리조직검사상 신경섬유초종으로 판명되었다.