THE TREATMENT RESULTS OF HEMOTHORAX IN BLUNT CHEST TRAUMA

Abstract

Background: Blunt chest trauma is a life-threatening emergency that has a variety of injuries, from chest wall contusions and rib fractures to lung and pleural injuries, from trachea and esophagus to heart and large vessels trauma, of which hemothorax is a common complication of blunt chest trauma. Diagnosis is based on signs and symptoms, including blood loss, pleural effusion syndrome, and imaging findings. Conservative treatment and thoracostomy are the most common treatments and succeed in almost all cases, while the rest require thoracotomy. Follow-up care is necessary to perform strategy changes immediately for the best overall results. Objectives: To study the clinical, imaging features, and treatment results of hemothorax in blunt chest trauma. Materials and methods: A prospective descriptive study of 41 patients with hemothorax was conducted at the Department of Thoracic Surgery, Can Tho General Hospital, from April 2022 to December 2022. Results: The mean age was 53.24 ± 8.97; 70.73% were male; traffic accident was the most common cause (73.17%); chest pain and dyspnea were the two most frequent symptoms, accounting for 97.56% and 48.78%, respectively; the syndrome of decreased breath sounds, dullness to percussion and decreased tactile fremitus was found in 78.05%. The mean number of rib fractures was 4.24 + 2.29; the most common ribs fractured were the 4th through 10th ribs (53.66%); hemothorax and hemopneumothorax accounted for 75.61% and 24.39%, respectively; 28 patients (68.29%) received conservative treatment, in which three patients (10.71%) worsing then received pleural drainage, as a whole, 16 patients in total received pleural drainage treatment; the overall treatment success rate was 97.56%, and 1 case (2.44%) had a complication of empyema; the length of hospital stay was 7.29  2.69 days and differed between the two groups of patients with minimal hemothorax and other hemothorax (p=0.049). Conclusions: Chest pain and dyspnea were the most common clinical symptoms; conservative treatment is common and follow-up is important; the overall treatment success rate was 97.56% and the length of hospital stay was 7.29  2.69 days.