Early thoracoscopy for the evacuation of undrained haemothorax.
OBJECTIVE
To evaluate the accuracy of radiological tests and the outcome after thoracoscopic evacuation of retained haemothorax.


METHODS
Prospective study.


METHODS
Academic trauma centre, USA.


METHODS
Of 703 patients with thoracic injuries, 58 (8%) were evaluated for and 15 (2%) were found to have, retained haemothorax.


METHODS
Plain chest radiographs (CXR) and thoracic computed tomograms (CT) 48 hours after admission, and thoracoscopic evacuation within 3-6 days of admission.


METHODS
Accuracy of radiological tests, morbidity, and mortality.


RESULTS
12 patients underwent early thoracoscopy with minimal morbidity, no mortality, and appreciable clinical and radiological improvement. Three patients who were not operated on developed empyemas. CXR was inaccurate in predicting the need for thoracoscopy. CT was the only test that predicted the need for evacuation of haemothoraces.


CONCLUSIONS
Thoracoscopic evacuation of retained haemothorax is safe and effective. The success of the procedure is assured by early intervention in appropriately selected patients. CT is the ultimate test on which to base decision-making.
Velmahos
G C
GC
Department of Surgery, University of Southern California School of Medicine, Los Angeles, USA.
Demetriades
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D000293:Adolescent; D000328:Adult; D004724:Endoscopy; D005260:Female; D006491:Hemothorax / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013898:Thoracic Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D013906:Thoracoscopy; D013907:Thoracostomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome