Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Traumatic hemothorax is one of the most common thoracic injuries in the world. There are a lot of
debates about the best method of management because of the possible risk of death and
development of subsequent complications.
OBJECTIVE:
The objective of this study is to decide the best type of management of traumatic hemothorax
(thoracostomy tube drainage versus thoracotomy) for life saving and prevention of subsequent
complications such as trapped lung with fibrothorax, and empyema.
METHODS:
This is a retrospective study of 165 consecutive patients with traumatic hemothorax admitted to
Al-Jamhoori teaching hospital in Mosul from 1st January 2010 to 1st January 2012. The parameters
that were used in this study were sex, age group, mechanism of injury, hemodynamic state at time
of according to volume of blood in the drainage bottle into5 groups. The patients were also
classified into 4 groups depending on their hemodynamic state at time of presentation.
RESULTS:
Thoracostomy tube drainage was done in the majority of cases as the mainstay of treatment, in
minority of cases it was followed by thoracotomy for those with massive hemothorax, severe
hypovolemic shock, associated thoracic injuries, or those with complications.
CONCLUSION:
Traumatic hemothorax should be treated initially by thoracostomy tube drainage except in very
urgent cases, and the decision for thoracotomy should be based on the hemodynamic state, the
volume of drained blood and the presence of associated thoracic injuries. A good initial care and
proper drainage of collected intrathoracic blood reduces the development of late complications and
the subsequent need for thoracotomy.
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