Spontaneous hemopneumothorax: is conservative treatment enough?
OBJECTIVE
Spontaneous hemopneumothorax is a rare disorder, occurring in 1% to 12% of patients with spontaneous pneumothorax. The present review was undertaken to emphasize the potential life-threatening condition of spontaneous hemopneumothorax and reassess the benefit of conservative treatment with chest tube drainage.


METHODS
From 1997 to 2002, 291 cases of spontaneous pneumothorax were treated in our department. Of these, 9 (3.09%) developed hemopneumothorax (> 400 ml). The clinical features of these patients and the results of conservative and surgical management were retrospectively reviewed.


RESULTS
Seven patients were treated conservatively and two required VATS and thoracotomy because of worsening clinical condition. The amount of aspirated blood ranged from 400 to 3700 ml (mean, 1533 ml). Six patients received a homologous blood transfusion.


CONCLUSIONS
In conclusion, hemopneumothorax is a serious condition complicating spontaneous pneumothorax. Conservative treatment is adequate in most cases and should be performed if bleeding persists for less than 24 hours after chest tube placement.
Haciibrahimoglu
G
G
Yedikule Hospital for Chest Disease and Thoracic Surgery, Department of Thoracic Surgery, Istanbul, Turkey. ghaciibrahim@yahoo.com
Cansever
L
L
Kocaturk
C I
CI
Aydogmus
U
U
Bedirhan
M A
MA
D015505:Chest Tubes; D015331:Cohort Studies; D004322:Drainage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006468:Hemopneumothorax / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013908:Thoracotomy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome