Hemothorax is a collection of blood in the space between the chest wall and the lung (the pleural cavity).
Causes, incidence, and risk factors
The most common cause of hemothorax is chest trauma. It can also occur in patients who have:
- Chest (thoracic) or heart surgery
- Death of lung tissue (pulmonary infarction)
- Tear in a blood vessel when placing a central venous catheter
Signs and tests
Your doctor may note decreased or absent breath sounds on the affected side. Signs of hemothorax may be seen on the following tests:
The goal of treatment is to get the patient stable, stop the bleeding, and remove the blood and air in the pleural space. A chest tube is inserted through the chest wall to drain the blood and air. It is left in place for several days to re-expand the lung.
When a hemothorax is severe and a chest tube alone does not control the bleeding, surgery (thoracotomy
) may be needed to stop the bleeding.
The cause of the hemothorax should be also treated. In people who have had an injury, chest tube drainage is often all that is needed. Surgery is often not needed.
The outcome depends on the cause of the hemothorax and how quickly treatment is given.
Calling your health care provider
Call 911 if you have:
Go to the emergency room or call the local emergency number (such as 911) if you have:
Use safety measures (such as seat belts) to avoid injury. Depending on the cause, a hemothorax may not be preventable.
Light RW, Lee YCG. Pneumothorax, chylothorax, hemothorax, and fibrothorax. In: Mason RJ, Broaddus CV, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 74.
Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, and Stephanie Slon.