Abstract
A 34-year-old man visited a hospital complaining of chest pain which appeared during baseball practice. Chest X-ray film revealed pulmonary collapse and hemopneumothorax in the left lung. A chest tube was inserted. He was brought into our hospital because the bloody discharge persisted that appeared to require surgical therapy. So thoracoscopic emergency operation was performed with the diagnosis of left hemopneumothorax. Removal of hematoma disclosed two torn pleural adhesion bands showing bleeding in the thoracic apex, and another bleeding point which was present near the superior intercostal vein. We coagulated all three bleeding points by video-assisted thoracic surgery, and diagnosed the case as spontaneous hemopneumothorax. The post-operative course was uneventful, and he was discharged on the 3rd postoperative day. Emergent operation is recommended for spontaneous hemopneumothorax, and it is very important to search the thoracic cavity thoroughly to detect all bleeding points.