HEMOTORAX - accumulation of blood in the pleural cavity. More often develops as a result of internal bleeding with a closed or open chest injury, after surgery on the organs of the chest cavity, less often with malignant tumors of the pleura and lung, tuberculosis of the respiratory system and other diseases. Often combined with pneumothorax (hemopneumothorax).
The clinical picture depends on the amount of spilled blood. With a small accumulation of it, manifestations may be absent or minor chest pains, coughing occur. As hemothorax increases, the symptoms of hemorrhage, compression of the lung and displacement of the mediastinal organs (shortness of breath, pallor, cyanosis , forced half-sitting position, tachycardia , decreased blood pressure) join. Continued bleeding and an increase in hemothorax can lead to the death of the patient.
The percussion and auscultation data are similar to those with effusion pleurisy (restriction of the mobility of the lower pulmonary edge on the affected side, blunting of percussion sound with the Damuazo line and weakening of breathing until the disappearance of respiratory sounds over the area of blood accumulation, etc.). To confirm or exclude the diagnosis, an X-ray examination is mandatory. With pleural puncture, blood is detected. . -
If hemothorax is suspected, urgent hospitalization in a surgical hospital is indicated. Transportation of a patient with hemothorax is performed in a half-sitting position; with severe coughing attacks, 1 ml of a 1% solution of morphine hydrochloride is subcutaneously injected, with pronounced signs of hypovolemia, blood substitute solutions are administered intravenously.
Treatment, as a rule, consists of pleural puncture with a thick needle, aspiration of blood, further compensation of blood loss. In cases where emergency hospitalization is not possible, pleural puncture is performed according to vital indications within the framework of emergency care. With continued bleeding and increasing hemothorax, urgent thoracotomy for hemostasis is indicated. In mild cases, you can limit yourself to conservative treatment (rest, antitussives, antibiotics). After the cessation of bleeding, the blood accumulated in the pleural cavity can dissolve or organize with the formation of massive pleural adhesions - the mooring line.