Hemothorax

Are you experiencing anxiety, restlessness and other similar problems along with a cool, pale skin? Watch out, for it may be a case of Hemothorax that you are having. Find out all about this traumatic chest condition, including its causes, symptoms, diagnosis and treatment.

Hemothorax Definition

It is a condition marked by the accumulation of blood in the pleural cavity – the space between the lung and the chest wall.

The disorder is also referred to as Haemothorax.

Hemothorax ICD 9 Code

The ICD 9 Code for this disorder is 511.8.

Hemothorax Incidence

The worldwide incidence of this condition is difficult to assess. In the U.S however, around 300,000 cases of this disease are annually reported.

Hemothorax Symptoms

The disease is usually characterized by problems like:

Picture of Hemothorax

Picture 1 – Hemothorax

  • Chest pain
  • Anxiety
  • Restlessness
  • Rapid, shallow respiration
  • Dyspnea
  • Hypotension
  • Low blood pressure
  • Unequal rise of chest
  • Cyanosis
  • Respiratory shortness
  • Abnormal heart rate
  • Cool, clammy skin
  • Pale appearance of mucosa around the mouth and the eyes

The last three symptoms can arise in case of a lung collapse in affected patients. The condition of sufferers can be termed critical in such cases. Treatment should be sought on an immediate basis. In the absence of an early cure, an affected individual may even die. Even in case of a less acute case of Hemothorax, a number of complications may arise.

Hemothorax Pathophysiology

In healthy individuals, a small quantity of fluid is present in the pleural cavity that surrounds the lungs. This helps lubricate and reduce surface tension. When a person breathes in, the lungs enlarge and the fluid fills the entire cavity. In patients affected with Hemothorax, the lung may actually collapse due to pressure exerted by the fluid. The pressure exerted by the fluid may also suppress the cardiac function.

What Causes Hemothorax?

The condition most commonly arises due to chest trauma. Traumatic Hemothorax arises due to piercing or blunt trauma to the chest. In case of an injury to the chest, an artery or a lung tissue may be lacerated (torn) by a rib. This can lead to an accumulation of blood in the pleural space. A large Hemothorax is often associate to the shock in a person who has suffered a chest trauma.

It may also result from:

  • Tuberculosis
  • Thoracic or heart surgery
  • Lung or pleural cancer
  • A defect in blood coagulation (clotting)
  • Insertion of a central venous catheter
  • Death of lung tissue (Pulmonary infarction)

An injury to the thorax, blunt or sharp, can lead to a tear (rupture) of the serous membrane that either covers the lungs or lines the thorax. This tear in the membrane allows spillage of blood into the pleural space. This equalizes the pressure between the lungs and the pleural space. In individuals affected with this disorder, the loss of blood may be huge. This is because either side of the thorax of a person can hold 30-40% of the total blood volume. Even a small injury to the chest wall may give rise to acute Hemothorax.

Hemothorax Diagnosis

Physicians begin the diagnosis of this disease by asking patients whether they have a history of blunt chest injury or a piercing wound. However, affected individuals may complain of mild to severe chest pain as well as shortness of breath even when no wounds are apparent.

Doctors check whether the breathing sounds emanating from the Hemothorax have reduced. Physicians may also tap over the affected area to detect dull sounds. The affected person may suffer from rapid heartbeat, restlessness and anxiety.

The signs of this problem may be detected with the aid of diagnostic tests like:

  • Chest X-ray
  • Needle aspiration of fluid from the pleural cavity (Thoracentesis)
  • Pleural fluid analysis, through microscope or simple observation
  • CT Scans, to identify blood clots or location of fluid

Hemothorax Treatment

The aim of treatment of this disorder is to stabilize the health of sufferers, remove blood from the pleural space, stopping the blood loss and inflating the collapsed lung again. The treatment can involve one or more of the following processes, depending on the condition of patients:

Image of Hemothorax

Picture 2 – Hemothorax Image

Thoracostomy

In this process, a tube is inserted through a small hole between two ribs in the wall of the chest to drain the accumulated blood. The chest tube is kept in position for a few days to expand the lung again.

Anticoagulants

Anticoagulants (Anti-clotting agents) may be given to patients to prevent clotting of blood in their chest cavity.

Blood transfusion

Some patients require a transfusion of blood as there can be loss of a considerable amount of blood. The source of bleeding also has to be detected and stopped.

Surgery

The requirement of an operative procedure depends on the nature of trauma suffered by the patient. Less than 10% affected individuals need a Throacotomy (surgical opening of the chest cavity) for removal of internal organs, blood vessels or blood clots or repairing of muscles.

Hemothorax Prognosis

The prognosis of this disease depends on its underlying cause and how fast treatment is administered. Chances of a complete recovery are higher if a sufferer gets proper treatment and does not suffer from severe ailments or wounds. Post-surgery, the outcome of this condition is excellent for its sufferers. If medical cure is not available or started immediately to stop leakage of blood, patients may suffer from respiratory failure. In worst cases, even death may occur. If an individual suffers from severe wounds, apart from Hemothorax, the outcome is difficult to be predicted.

Hemothorax Compliations

Some of the possible complications of this disorder include:

  • Empyema
  • Pneumothorax
  • Scarring of the pleural membranes (Fibrosis)
  • Lung collapse, resulting in respiratory failure
  • Shock
  • Death

Hemothorax Prevention

The prevention of this condition is mainly possible by avoiding any injury or trauma to the chest. This can be done by following safety measures, such as using seat belts. Other causes of this disorder are less likely to be avoided.

 

If you are suffering from a severe chest trauma or shortness of breath, call 911 to get immediate medical attention. Unless treated on an urgent basis, the condition might give rise to acute health complications or even cause of death of sufferers.

References:

http://www.nlm.nih.gov/medlineplus/ency/article/000126.htm

http://emedicine.medscape.com/article/2047916-overview#a0101

http://www.mdguidelines.com/hemothorax-traumatic

http://www.wisegeek.com/what-is-a-hemothorax.htm

 

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