Abstract
A series of forty cases of traumatic hemothorax is presented. The immediate and late therapy of these cases is discussed. The following conclusions are drawn: (1) Immediate aspiration of pleural blood by thoracentesis or closed catheter drainage is recommended. The advantages of the immediate over delayed aspiration include the detection of continued bleeding and the prevention of clotted hemothorax. The fear of reinitiating bleeding by early aspiration is unfounded. (2) Postoperative hemothorax, in comparison with hemothorax due to thoracic injuries, is more likely to clot and represents a more difficult therapeutic problem. (3) The treatment of hemothorax by surgical or enzymatic decortication has an inherent, although small, risk of morbidity and mortality. (4) In selected cases, satisfactory spontaneous resolution of clotted hemothorax will occur without significant residual damage. (5) Surgical decortication will remain a valuable method for the treatment of clotted hemothorax when the conservative method of treatment is not applicable.
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