Spontaneous haemopneumothorax: a surgical emergency.

Sharpe DA, Dixon K, Moghissi K

Thoracic Endoscopy and Laser Service, Goole and District General Hospital,
Humberside, UK.

Eur Respir J, 8: 9, 1995 Sep, 1611-2

We describe two cases of spontaneous haemopneumothorax treated
successfully at emergency thoracotomy. We emphasize the importance of torn
apical vascular adhesions as a source of intrathoracic haemorrhage in these
two cases.

Spontaneous hemothorax.

Schwarzman PS

JACEP, 8: 6, 1979 Jun, 235-7

A 31-year-old man presented to the emergency department with dyspnea and
pleuritic chest pain resulting from a spontaneous hemothorax. A tube
thoracostomy was performed on the left side and 700 cc of blood removed.
Another 1800 cc of blood oozed from the chest tube. Open thoracotomy was
performed in the operating room. There were approximately 1 to 2 liters of
blood and clot in the chest cavity. Multiple bleeding points in the apex were
ligated and wedge resection was done. Spontaneous hemothorax may represent a
form of spontaneous hemopneumothorax or it may be a complication of a
variety of situations. Open thoracotomy may be necessary for definitive
diagnosis and treatment.

Spontaneous hemopneumothorax with aberrant vessels found to be the Source
of bleeding: report of two cases.

Muraguchi T, Tsukioka K, Hirata S, Fukuda S, Mizugami K, Kishi A, Morimoto
Y, Fukuda Y, Ohtori K
Department of Surgery, Osaka Municipal Citizen's Hospital, Japan.

Surg Today, 23: 12, 1993, 1119-23

We report herein our experience of two cases of spontaneous pneumothorax
in which the source of bleeding was found to be aberrant vessels. Both
patients were successfully treated by early thoracotomy. Case 1 was a
23-year-old male in whom chest X-ray revealed an air-fluid line and a bulla
with a narrow restiform shadow connecting the pleural cupola. Angiography
clearly visualized aberrant vessels branching from the costocervical trunk,
distributed in and around the bulla in the apex of the lung, being the possible
source of bleeding. These aberrant vessels were confirmed at surgery and resected. Case 2 was a
56-year-old male who underwent thoracotomy for persistent bleeding. At
bleeding vessel from the pleural cupola was seen and ligated. The remnant of
the vessel was located in the apex of the lung, and resected with the bulla.
Thus, the rare entity of a congenital aberrant vessel lying concealed as a
possible source of bleeding should be borne in mind.

Spontaneous haemopneumothorax: a rare clinical entity.

Baas P, Stam J
Pulmonary Dept, Free University Hospital, Amsterdam, The Netherlands.

Eur Respir J, 4: 8, 1991 Sep, 1027-8

A 39 yr old man presented with a spontaneous pneumothorax. On initial
pleural drainage 120 ml of haemorrhagic fluid were collected. Twenty four
hours, after re-expansion of the lung, shock developed and 1,200 ml of
haemorrhagic fluid were spontaneously collected. The diagnosis
haemopneumothorax was considered and at operation a bleeding vessel, which
originated from the parietal pleura, was located and coagulated. The occurrence
of an air fluid line at radiological examination, the development of a
haemorrhagic pleural effusion and shock should alert the physician of this
entity. This case stresses the importance of early recognition and surgical
intervention because of the possible lethal evolution.

Haemopneumothorax and mediastinal emphysema. A dramatic rescue in the
South Atlantic.

Kabuubi JB
Princess Mary's Royal Air Force Hospital, Akrotiri.

J R Army Med Corps, 136: 1, 1990 Feb, 36-9

Spontaneous haemopneumothorax has a high mortality and morbidity which
increase if the treatment is delayed. A patient with tension haemopneumothroax
and mediastinal emphysema,rescued from a fishing boat in the middle of the
South Atlantic, responded well to conservative treatment, despite delay in
initiating treatment. The clinical presentation and management are discussed.

An unusual presentation of sarcoidosis--spontaneous haemopneumothorax.

Gomm SA

Postgrad Med J, 60: 707, 1984 Sep, 621-3

Pneumothorax is a very rare complication of early stage sarcoidosis. A
young man is reported with a left sided spontaneous haemopneumothorax and a
right apical pneumothorax in association with early sarcoidosis.

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