An examination about the relationship between thoracic drainage for spontaneous hemopneumothorax and hemorrhagic shock

Abstract

Purpose：Spontaneous hemopneumothorax （SHP） is a rare, but troublesome condition as it may cause an abrupt hemorrhagic shock. We clarify the clinical feathers of SHP. Methods：Here we report 9 cases of SHP from 2014 to 2018. Results：8 cases underwent chest tube drainage. Of these, 3 cases experienced hemorrhagic shock. Two of these 3 cases required urgent surgery. Of 6 cases without shock, 3 cases subsequently required surgery due to air leakage or increased blood loss. Eventually, 5 cases required surgery and 6 cases required blood transfusion. Video-assisted thoracoscopic surgery（V ATS） was performed in all cases and hemostasis was successfully achieved without any complications by cauterizing the abnormal vessels arose from the chest wall. Mean operative time was 83 minutes. The median hospitalization in surgery group was 7 days （4-11） compared to 9.5 days （6-11） in conservative therapy group. Discussion：VATS should be considered when the patient is diagnosed as SHP in order to prevent hemorrhagic shock requiring blood transfusion. Conclusion：Caution should be exercised even in patients with conservative therapy regardless of whether the chest tube was inserted or not.