Causes and Condition of Hemothorax

What is this Condition?

In hemothorax, blood from damaged vessels enters the lungs. Depending on the amount of bleeding and the underlying cause, hemothorax may be associated with varying degrees of lung collapse.

What Causes it?

Hemothorax usually is caused by blunt or penetrating chest injury, such as a gunshot wound. In fact, about 25% of people with such an injury have hemothorax. Less often, it is caused by chest surgery, pulmonary infarction, a tumor or dissecting aneurysm in the chest, or blood-thinning drugs.

What are its Symptoms?

The person with hemothorax may experience chest pain, rapid breathing, and mild to severe shortness of breath, depending on the amount of blood in the lungs and associated disease. If respiratory failure results, the person may appear anxious, restless, possibly unresponsive, and blue in skin color; marked blood loss produces low blood pressure and shock. The affected side of the chest expands and stiffens, while the unaffected side rises and falls with the person's gasping respirations.

How is it Diagnosed?

Characteristic symptoms with a history of trauma strongly suggest hemothorax. A doctor will examine the chest using a stethoscope. Other tests include thoracentesis, chest X-ray, and arterial blood gas studies.

How is it Treated?

Treatment is designed to stabilize the person's condition, stop the bleeding, remove blood from the space around the lung, and reexpand the lung. Mild hemothorax usually clears in 10 to 14 days, requiring only observation for further bleeding. In severe hemothorax, fluid must be removed with a needle from the pleural cavity.

After the diagnosis is confirmed, a chest tube is inserted. If the chest tube doesn't improve the persons condition, a surgical procedure called a thoracostomy may be needed to remove blood and clots and to control bleeding.