Hemothorax is a collection of blood in the space between the chest wall and the lung (the pleural cavity).
The most common cause of hemothorax is chest trauma. Hemothorax can also occur in people who have:
Your health care provider may note decreased or absent breath sounds on the affected side. Signs or findings of hemothorax may be seen on the following tests:
The goal of treatment is to get the person stable, stop the bleeding, and remove the blood and air in the pleural space.
If a chest tube alone does not control the bleeding, surgery (thoracotomy) may be needed to stop the bleeding.
The cause of the hemothorax will be also treated. The underlying lung may have collapsed. This can lead to breathing difficulty. In people who have had an injury, chest tube drainage may be all that is needed. Surgery may not be necessary.
WHAT TO EXPECT AT THE EMERGENCY DEPARTMENTThe provider will measure and monitor the person's vital signs, including oxygen saturation, pulse, breathing rate, and blood pressure. Symptoms will be treated as needed. The person may receive:
The outcome depends on the cause of the hemothorax, the amount of blood loss and how quickly treatment is given.
In the case of major trauma, the outcome will additionally depend on the severity of the injury and the rate of bleeding.
Complications may include:
Call 911 or the local emergency number if you have:
Go to the emergency room or call the local emergency number (such as 911) if you have:
Use safety measures (such as seat belts) to avoid injury. Depending on the cause, a hemothorax may not be preventable.
Light RW, Lee YCG. Pneumothorax, chylothorax, hemothorax, and fibrothorax. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray & Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 81.
Raja AS. Thoracic trauma. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 38.
Semon G, McCarthy M. Chest wall, pneumothorax, and hemothorax. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:1146-1150.BACK TO TOP
Review Date: 7/1/2020
Reviewed By: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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