Spontaneous Hemopneumothorax with Massive Bleeding; a case report

Abstract

A-26-year-old male was admitted to our hospital because of chest pain and dyspnea. Chest X-ray film on admission revealed moderate pleural effusion with right pneumothorax. At thoracentesis, blood was aspirated and the chest was drained, but bleeding did not stop, so emergency thoracotomy was performed. There was a ruptured bulla at S1a with several vessels in its wall, from one of which a thrombus was removed after the lung was re-expanded, and active bleeding originated from it. Wedge resection was performed. The post operative course was uneventful.For spontaneous hemopneumothorax, tube drainage is usually performed first, but it may increase bleeding in some cases. Before doing tube drainage for hemopneumothorax, preparations should be made for possible emergency thoracotomy.