Isolated Hemothorax Following Thoracic Trauma: Analysis of 57 Cases

Aim: The aim of this study was to review cases with isolated hemothorax after thoracic trauma, to assess the diagnostic and treatment methods, and to discuss the determining factors of morbidity and mortality. Material and Method: A total of 57 patients were examined retrospectively. All patients underwent tube thoracostomy and underwater seal as the initial treatment approach. Emergency thoracotomy was performed on cases with continuing drainage from the chest tube, expanding hemothorax on the posteroanterior (PA) chest x-ray, and with hemodynamic instability. Result: Hemothorax occurred as a result of penetrating trauma in 31 (54.38%) and due to blunt trauma in 26 (45.61%) cases. Of the cases, 49 (85.96%) underwent tube thoracostomy drainage. All the 8 cases (14.03%) that underwent emergency thoracotomy had penetrating trauma. Mortality occurred in one patient (1.75%) who had penetrating trauma and who underwent emergency thoracotomy. The morbidity rate in patients with blunt trauma was significantly higher than those with penetrating trauma (p<0.0001). Discussion: Accurate diagnosis and appropriate surgical intervention in cases with traumatic hemothorax is essential for reducing the morbidity and mortality. Chest tube insertion and underwater seal application should be the initial treatment modality and successful in most cases. Emergency thoracotomy is life-saving in indicated patients. The need for thoracotomy is higher in isolated hemothorax due to penetrating chest trauma.