Case Report
Volume: 4 | Issue: 2 | Published: Mar 08, 2020 | Pages: 84 - 87 | DOI: 10.24911/ejmcr/173-1579102779
Delayed massive hemothorax from pulmonary laceration complicating rib fractures: a rare case presentation
Authors: Lui Sze Yee , Nurkhairulnizam Abd Halim , Ida Zaliza Zainol Abidin
Article Info
Authors
Lui Sze Yee
Emergency and Trauma Department, Hospital Tuanku Fauziah, Perlis, Ministry of Health, Malaysia
Nurkhairulnizam Abd Halim
Emergency and Trauma Department, Hospital Tuanku Fauziah, Perlis, Ministry of Health, Malaysia
Ida Zaliza Zainol Abidin
Emergency and Trauma Department, Hospital Tuanku Fauziah, Perlis, Ministry of Health, Malaysia
Publication History
Received: January 15, 2020
Revised: February 20, 2020
Accepted: March 01, 2020
Published: March 08, 2020
Abstract
Background: The incidence of delayed hemothorax from blunt chest trauma was only up to 7.4%, massive hemothorax being much rarer. Case Presentation: We report a case of this uncommon situation involving a 65-year old gentleman with alleged motor-vehicle accident (MVA) sustaining multiple right 2nd to 8th rib fractures. Despite initial in-patient monitoring, he presented to us again on Day-7 post-MVA with acute shortness of breath and chest pain. Chest radiograph showed homogenous opacity over right lung field with the blunting of costophrenic angle. Right thoracostomy tube drained 800 ml of frank blood upon insertion with a total of 1,250 ml within 12 hours. The patient was subsequently transferred to cardiothoracic center for definitive care. Conclusion: Therefore, the possibility of delayed sequelae following blunt chest trauma should be considered and communicated to the patient to encourage vigilance and home monitoring. Despite rarely requiring emergency surgery, delayed massive hemothorax is potentially life threatening.
Keywords: Traffic accidents, hemothorax, thoracostomy, rib fractures, non-penetrating wounds, case report, green
