Hemothorax natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Bleeding into the pleural space is exposed to the motion of the diaphragm, lungs, and other intrathoracic structures. The agitation of cardiac and respiratory movement defibrinates the blood, and a fibrin clot thus formed is deposited on the layers of pleura. After several hours, clot formation is inevitable and it should be evacuated. if left untreated, it may progress to develop some complications.

Natural History

Bleeding into the pleural space is exposed to the motion of the diaphragm, lungs, and other intrathoracic structures. The agitation of cardiac and respiratory movement defibrinates the blood, and a fibrin clot thus formed is deposited on the layers of pleura. Within several hours of cessation of bleeding, clot formation is inevitable and it will be difficult to remove. The membrane continues to thicken by progressive deposition, so the clotted haemothorax should be evacuated within a reasonable time after onset of bleeding. Chronic and retained hemothorax may progress to develop respiratory distress, lung entrapment with impaired pulmonary function, retained clot, chronic fibrothorax, empyema and extended hospitalization if left untreated.

Complications

• Respiratory distress
• Lung entrapment
• Impaired pulmonary function
• Retained clot
• Chronic fibrothorax
• Empyema
• Extended hospitalization
• Atelectasis
• Pneumonia