title: Spontaneous hemopneumothorax simulating acute abdominal affections.
abstract: Spontaneous hemopneumothorax (SHP) is a rare potentially life-threatening condition that occurs in predominantly young adolescents. The resultant massive hemorrhage leading to hypovolemic shock can be a surgical emergency. It constitutes 1-12% of all spontaneous pneumothoraces and presents with two cardinal features, chest pain and dyspnea. However, the pain of SHP may be confined to the abdomen secondary to the irritation of diaphragmatic pleura, which produces signs simulating an acute abdomen. SHP masquerading as an abdominal affection is apparently regarded as extremely rare. We present a case of a 16-year-old male with SHP presenting features simulating acute gallbladder disease. After prompt diagnosis with appropriate surgical intervention, he had an uneventful recovery. Our experience emphasizes the importance of careful and thorough chest examination for each child with atypical pictures for abdominal pain to exclude possible extra-abdominal lesions, even rare as SHP.
authors.affiliation: Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Pediatric Emergency, Department of Emergency, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Tai-Heng
authors.initials: TH
authors.lastname: Chen
authors.forename: Yung-Hao
authors.initials: YH
authors.lastname: Tseng
authors.forename: Chien-Ming
authors.initials: CM
authors.lastname: Tseng
authors.forename: Hung-Hsing
authors.initials: HH
authors.lastname: Chiang
authors.forename: Tzeng-Jih
authors.initials: TJ
authors.lastname: Lin
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis*; D000208:Acute Disease; D000293:Adolescent; D003937:Diagnosis, Differential; D005705:Gallbladder Diseases / Q000175:diagnosis; D006468:Hemopneumothorax / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D011859:Radiography