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KMID : 1161920200170010016
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Journal of Medicine and Life Science
2020 Volume.17 No. 1 p.16 ~ p.20
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Massive Hemothorax Resulting from Spontaneous Pneumothorax
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Hong Ji-Yeon
Kim Su-Wan
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Abstract
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Spontaneous hemopneumothorax is a rare disease, and it can cause life threatening condition. It is characterized by the accumulation of more than 400 ml of blood and air in the pleural cavity without any other apparent causes. A previously healthy 22-year-old female patient presented with acute chest pain and dyspnea. Chest X-ray and computed tomography revealed a massive hemopneumothorax in the left hemithorax. The images showed completely collapsed left entire lung with right-sided tracheal deviation, several pleural adhesion bands, and fluid collection with air-fluid level. We emergently performed a closed thoracostomy, and then 560 ml of fresh bloods were initially drained. We considered an emergent video-assisted thoracoscopic surgery for pulmonary wedge resection and bleeding control because of the massive hemothorax. However, the patient’s vital signs were stabilized after blood transfusion and supportive cares for re-expansion pulmonary edema. The patient discharged from the hospital on 11th in-hospital day after removal of the chest tube, and there had not been any recurrence of the pneumothorax for 10 months. We suggest that spontaneous hemopneumothorax could be treated by conservative therapies, and that it seems to have low recurrence rates.
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KEYWORD
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hemothorax, pneumothorax, closed, thoracostomy
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