In the literature, a hemopneumothorax is defined as an abnormal accumulation of blood (> 400 mL) in the pleural space (between the visceral and parietal layers of the pleura), predominantly as a complication of a pneumothorax (encompassing about 5% of cases) [1] [2] [3] [4]. Various blood vessels located in the proximity of this anatomical landmark are identified as the source of bleeding (vessels in the adhesions between pleural layers are most common, whereas congenital aberrant vessels or a vascularized bulla are also described) and the majority of reports indicated that the cause is predominantly spontaneous, in the absence of trauma or other precipitating events [1] [3] [5] [6] [7]. In rare cases, however, chest trauma might lead to vessel rupture and consequent hemopneumothorax [7]. For as yet unknown reasons, this disorder principally occurs in adolescents, with a stronger predilection towards the male gender [2] [3] [6]. The clinical presentation is comprised of the sudden spontaneous appearance of respiratory complaints, such as dyspnea and chest pain, but up to 30% of individuals suffer from hypovolemic shock, manifesting as hypotension and poor general condition [6] [8]. The importance of an early diagnosis stems from the life-threatening nature of hemopneumothorax, which could also be complicated by infections, an inability of the lung to regain its structure or the persistence of a pneumothorax [6].

• Intermittent Fever

  She also complained of intermittent fevers, dry cough, night sweats, and 30-lb weight loss. Her past medical history included mild intermittent asthma and keloids, which were extensive, disfiguring, and painful. [journals.lww.com]

• Pleuritic Pain

  Increase in size of the collection, development of an air-fluid level, or the new onset of symptoms (eg, fever, cough, dyspnea, pleuritic pain) may warrant CT evaluation and reassessment for surgical intervention. [healthjade.net]

• Hypotension

  I (perhaps mistakenly) thought that VATS procedure would be an contraindication in such a hypotensive patient and it would be more safe to perform an open operation. [ctsnet.org]

  The clinical presentation is comprised of the sudden spontaneous appearance of respiratory complaints, such as dyspnea and chest pain, but up to 30% of individuals suffer from hypovolemic shock, manifesting as hypotension and poor general condition. [symptoma.com]

  Patients can also obviously represent chest trauma, possibly hypotension and shock. Physical exploration can reveal possible segments of ulcers, subcutaneous emphysema or hematoma. [healthgala.info]

  The reduction in venous return will reduce the preload of the left ventricle, leading to a decrease in cardiac output and consequential poor perfusion and hypotension. [emsworld.com]

  The physical examination revealed hypotension (90/50mmHg), tachycardia (140/min) and decreased partial O2 pressure (SPO2=90). Pelvic pain and a subcutaneous hematoma were detected. [file.uroturk.org.tr]

• Pulse Deficit

  Injuries may range from laceration of the vessel to pseudoaneurysm or thrombus formation. 17 One study has shown a 24% incidence of associated vascular injury when a first rib fracture is seen as a result of chest trauma. 18 Pulse deficits, a widened [healio.com]

• Angiomatosis

  Here, we report the first case in the literature on pneumothorax-associated fibroblastic lesion in combination with localized pleural angiomatosis in a 19-year-old Caucasian male, resulting in massive spontaneous hemopneumothorax and hypovolemic shock [ncbi.nlm.nih.gov]

  […] surgical management. ( 25409674 ) Tay CK...Asmat A 2015 18 Assessment of spontaneous hemopneumothorax: Indications for surgery. ( 25614480 ) Inafuku K...Masuda M 2015 19 Pneumothorax-associated fibroblastic lesion in combination with localized pleural angiomatosis [malacards.org]

• Night Sweats

  She also complained of intermittent fevers, dry cough, night sweats, and 30-lb weight loss. Her past medical history included mild intermittent asthma and keloids, which were extensive, disfiguring, and painful. [journals.lww.com]

• Palmar Hyperhidrosis

  […] a case report. 61 Allard E...Veber B 31651338 2019 7 Factors affecting mortality in traumatic diaphragm ruptures. 61 Tokgoz S...Gundogan G 31701506 2019 8 Needlescopic Video-Assisted Thoracic Bilateral T4 Sympathicotomy for the Treatment of Primary Palmar [malacards.org]

• Numbness of the Hand

  The patient achieved an inadvertent subclavian arterotomy, causing tingling and numbness in the hand and arm, an unusual "high," and blood filling the pleura, collapsing the lung. [ncbi.nlm.nih.gov]

As hemopneumothorax may be fatal if undiagnosed early, physicians must include this clinical entity in the differential diagnosis of sudden chest pain and shock in otherwise healthy adolescents [3] [8]. Thus, a thorough patient history regarding the course and progression of symptoms (as well as exclusion of preexisting illnesses or events that might point to an underlying cause) and a detailed physical examination, with an emphasis on pulmonary auscultation, are vital steps in raising clinical suspicion [9]. A complete laboratory workup, particularly focused on a complete blood count (CBC), hematocrit levels (both from venous blood and the aspirated blood), and a full coagulation panel, can provide useful clues for confirming the diagnosis [4]. Imaging studies, however, are the gold standard for the diagnosis of hemopneumothorax and should be employed as soon as possible. Plain radiography of the chest and ultrasonography have been shown to be very useful initial methods for evaluation of patients in whom pneumothorax and hemopneumothorax are suspected [9]. Computed tomography (CT), particularly contrast-enhanced, is often used as a definite method for confirming the diagnosis and the underlying process that caused the bleeding (if present) [4] [7] [9].

• Kerley A Lines

  CXRs may show fluid in the alveolar walls, Kerley B lines, increased vascular shadowing in a classical batwing perihilar pattern, upper lobe diversion (increased blood flow to the superior parts of the lung), and possible pleural effusion. [ncbi.nlm.nih.gov]

• Kerley B Lines

  CXRs may show fluid in the alveolar walls, Kerley B lines, increased vascular shadowing in a classical batwing perihilar pattern, upper lobe diversion (increased blood flow to the superior parts of the lung), and possible pleural effusion. [ncbi.nlm.nih.gov]

• Bilateral Hilar Adenopathy

  The chest radiograph showed bilateral hilar adenopathy and diffuse interstitial infiltrates. [journals.lww.com]

MT + VATS is an easy accessible and safe procedure that could be applied as an initial treatment method in the patient with spontaneous hemopneumothorax, especially in the treatment of the patients with active hemorrhage and massive blood clot in the [ncbi.nlm.nih.gov]

Spontaneous hemopneumothorax--results of conservative treatment. [archive-ouverte.unige.ch]

Hemopneumothorax developing soon after metastasis to the lung indicates on unfavorable prognosis. [ncbi.nlm.nih.gov]

The symptoms, clinical forms, differential diagnosis, course, prognosis and therapy of spontaneous hemopneumothorax are discussed in chapters 4, 5, 7 and 8. [jamanetwork.com]

Spontaneous cases of hemopneumothorax have an excellent prognosis once the fluid and air is removed from the chest. [healthline.com]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

One of the extraordinary causes of hemopneumothorax is rupture of an apically located aberrant artery after pneumothorax, which is noticed as a third etiological factor in the literature. [tjtes.org]

Although many theories about the pathogenesis were suggested, the etiology of this syndrome remains obscure. [minervamedica.it]

Keywords Adult — Chest Tubes — Drainage — Female — Hemopneumothorax/etiology/therapy — Humans — Male — Recurrence — Thoracotomy — Treatment Outcome Identifiers PMID: 10786105 Full text Article (Published version) (1.5 MB) - Limited access to UNIGE Structures [archive-ouverte.unige.ch]

Although patients with chest trauma are often encountered with hemothorax, the simultaneous rupture of RV wall and pericardium is a rare etiology. [onlinejcf.com]

We evaluated their epidemiology and clinical features by comparing them with those of 681 patients with spontaneous pneumothorax treated during the same period. [ncbi.nlm.nih.gov]

Epidemiology Approximately 5% of patients with pneumothorax will have concomitant hemothorax 6. [radiopaedia.org]

Epidemiology. Approximately 5% of patients with pneumothorax will have concomitant hemothorax 6.. Pathology. [najdi.si]

Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Irfan Dotani Synonyms and Keywords: Hematothorax; haemothorax Overview Historical Perspective Classification Pathophysiology Causes Differentiating Hemothorax from other Diseases Epidemiology [wikidoc.org]

[…] angiomatosis: A possible cause of juvenile spontaneous hemopneumothorax. ( 25749626 ) Roncati L...Maiorana A 2015 20 Spontaneous hemopneumothorax simulating acute abdominal affections. ( 23169600 ) Chen TH...Lin TJ 2014 21 Spontaneous hemopneumothorax: epidemiological [malacards.org]

Also discussed will be assessment and treatment problems relating to the pathophysiology of these injuries. [emsworld.com]

Pathophysiology Endometriosis can attach to the lung, forming chocolate-like cysts. [answers.yahoo.com]

Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Irfan Dotani Synonyms and Keywords: Hematothorax; haemothorax Overview Historical Perspective Classification Pathophysiology Causes Differentiating Hemothorax from other Diseases Epidemiology [wikidoc.org]

Three ways of entry of air into the pleural cavity are described within the pathophysiology of pneumothorax: (A) communication between the alveolar spaces and the pleura, (B) the presence of organisms that produce gas in the pleural space, and (C) the [hindawi.com]

View Article PubMed Google Scholar Moore FA, Moore EE, Haenel JB, Waring BJ, Parsons PE: Post-traumatic pulmonary pseudocyst in the adult: pathophysiology, recognition, and selective management. [jmedicalcasereports.biomedcentral.com]

Preventive antibiotic usage in traumatic thoracic injuries requiring closed tube thoracostomy. Chest 1994;106:1493-1498. Fallon WF Jr, Wears RL. [east.org]

Treatment for hemopneumothorax is aimed at draining the air and blood in the chest, returning the lung to normal function, preventing complications, and repairing any wounds. [healthline.com]

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8. Hart SR, Willis C, Thorn A, et al. Spontaneous haemopneumothorax: are guidelines overdue? Emerg Med J 2002;19:273–274.
9. Kakaris S, Athanassiadi K, Vassilikos K, Skottis I. Spontaneous hemopneumothorax: a rare but life-threatening entity. Eur J Cardiothorac Surg. 2004;25(5):856-858.