Causes, symptoms and treatment of hemothorax

What is hemothorax?

Hemothorax is the accumulation of blood in the slit-like space located between the visceral and parietalnami the pleural layers of the lung. This phase is also called the pleural region, which is in the normal state contains serous fluid in small quantities. Big encyclopaedic dictionary describes a hemothorax (derived from Greek thorax – chest + haima - blood), as the accumulation of blood the pleural cavity due to internal bleeding.

During the filling of the pleural region blood due to several reasons, there is a compression of the lung, and organs such as the thymus gland, the trachea, aortic arch and its branches, the upper section of the Vena cava with the main tributaries are shifted in the opposite direction.

Doctors distinguish from places of a congestion of blood and its quantity hemothorax:

• large or total hemothorax, when the blood fills the pleural region;
• apical – blood accumulates in the area of apex of lung;
• small filling level of the blood does not reach the angle of the scapula;
• interlobar blood is in the interlobar gaps;
• nudepregnancy – blood within the pleural region adjacent to the aperture;
• limited or summany – the blood is in the pleural region bounded spikes;
• parallelnyy – the blood located in the region near the ribs;
• paramedicales – blood is located in the region adjacent to the mediastinum;
• coiled – collected blood was subjected to coagulation.

The severity of the hemothorax and the overall clinical picture is determined depending on the volume received in the pleural region of the blood, total blood loss, the degree of compression of the intrathoracic organs and the presence or absence of infection.

The most common cause of hemothorax is chest trauma, in violation of the integrity of blood vessels, but there are other factors responsible for the accumulation of blood.

Causes of hemothorax

Experts identify several reasons that lead to the development of the pathological state, namely:

• The appearance of clusters of blood due to open or closed chest injuries. Most often they occur due to an accident,gunshot or knife wounds, rib fractures, a fall from a height or other taurkalni injuries (according to statistics 70% of cases, wounds are right). Blood in the pleural region accumulates due to damage of various organs of the chest (diaphragm, heart, lungs) or abdominal cavity (liver, spleen), as well as intercostal vessels, branches of the aorta or internal thoracic artery.

• Less common, but still encountered reason for the occurrence of hemothorax, can be a variety of serious diseases. Tuberculosis and cancer of the lung or pleura, aortic aneurysm (widening, and then the gap segment due to several reasons), benign and malignant neoplasms in the chest wall or the mediastinum, hemorrhagic diathesis, heart attack lung tissue, impaired blood clotting (coagulopathy) – all of these diseases can become pathological causes that can lead to the development of hemothorax.

• Hemothorax may occur following surgery, performed operations on lungs and pleura, a pleural region, as a result of taking the diagnostic or therapeutic pleural puncture (thoracocentesis), installation of a catheter for Central veins. This so-called iatrogenic causes of hemothorax.

In General, the causes of hemothorax can be divided into three main groups: traumatic, pathological and iatrogenic.

Symptoms of hemothorax

Depending on the strength of bleeding, amount of blood poured out, displacement bodies sidestroke and compression of the lung will be more or less pronounced symptoms:

• If the hemothorax is small and the blood has not reached the level of the scapula, the injured person may complain of pain in the chest that worsens during coughing, and shortness of breath easy.
• If the hemothorax is large or medium in size the symptoms show up very brightly. People complaining even during quiet breathing and a slight cough on a sharp, strong pain in the chest radiating to the shoulder and the back, General weakness occurs, the pressure drops, shallow breathing increases. Without treatment, respiratory and cardiovascular disorders continue to worsen, even at low physical load victim experiencessharp pain may not be in a horizontal position and is forced to accept a sedentary or polusidya pose.

• Severe hemothorax is characterized symptoms such as: tachycardia, dizziness, fainting, cold sweats, severe pain in the chest, anemia, pale skin.

• If the hemothorax is accompanied by fractures of the ribs, often there is subcutaneous emphysema, hematoma in soft tissue, the rupture of the lung appears hemoptysis.
• If streamed the blood clotted, the person feels breathless and severe pain in the chest, lung tissue down to the sclerotic processes of the respiratory function is disturbed.
• When hemothorax, are infected there is fever with strong chills, fatigue, General intoxication.

No matter what the severity or leaking hemothorax, there will be breathing problems and tenderness in the chest area. For the diagnosis of severity and to clarify the diagnosis is carried out x-ray or CT scan, which is a more reliable way to detect the accumulated blood. In addition, you can further identify the root cause of hemothorax, for example, to detect the tumor. If necessary, doctors take a puncture of the accumulated blood, it allows to detect bacteria or fungi, and cell type.

Treatment of hemothorax

Modern methods of treatment allow not only to identify but also to resolve the hemothorax. Naturally, the choice of methods of healing will depend on the type of hemorrhage, the severity of the symptoms, the causes of hemothorax.

Small hemothorax can be eliminated in conservative ways: assigned to symptomatic treatment, immunoreactive, perhaps the use of antibiotics, desegregate therapy. The bleeding quickly stopped. If fluids have accumulated a small number, the human body is able to cope with this condition within approximately 2 weeks. But the patient must be under constant supervision to exclude the probability of occurrence of rebleeding or the occurrence of a bacterial infection.

If you want to aspiration of blood, it is thoracocentesis or drainage of the affected area. Inside introduced antibiotics, antiseptics and proteolytic enzymes. Surgical intervention is carried out with the clotted hemothorax in cases where the spreading of light is impossible and hurtthe vital organs. If damaged large vessels, the operation is performed on an emergency basis of thoracic surgery.

The success of treatment depends on the type of injury or the nature of the disease that caused the hemothorax. Timely treatment for medical assistance gives them a better chance at successful removal of the accumulated blood and uncomplicated course of the disease. Prevention of hemothorax is the prevention of injuries and medical observation despite the risk of its occurrence due to various diseases.