出血性ショックをきたした自然血気胸の1例

抄録

The patient was a 27 year-old male, who was admitted because of sudden chest pain while working. On admission the patient appeared severely anemic due to moderate loss of blood which led him to shock. Chest X-ray film on admission revealed a moderate amount of fluid together with left pneumothorax. Immediate drainage of the left pleural cavity, yielded about 2500ml of blood with bubbles. Since bleeding and air leakage continued, thoracotomy was performed. There was an evidence of rupture of a bulla at Sl+2 and bleeding from rupture of the pleura adhering to the bulla. Wedge resection was performed and the bleeding region was sutured with pleura. However, the chest X-ray taken the next day showed continuation of hemorrhage in the pleural cavity and the chest had to be re-opened. Bleeding originated from the same portion, namely at the rising point of the left subclavian artery pleural branch. This vessel was closed by suture. The postoperative course was favorable.
Through this experience hemopneumothorax should be treated surgically in terms of certainty of hemostasis and shortening the period of hospitalization.