Haemothorax

Haemothorax is where blood accumulates within the pleural cavity. The most common cause of this is trauma, typically after a rib fracture as it damages the intercostal vessels. Other causes are Iatrogenic (e.g. post-lung biopsy), Malignancy, Blood vessel disorders, and Clotting disorders.

Main presenting symptoms are Chest pain and Worsening dyspnoea.

O/E:

• Dullness to percussion

• Reduced breath sounds

• Reduced chest expansion

• Tracheal deviation if large enough

• Surgical emphysema with blunt injury

• Flail segment in those with a large injury

  • Chest wall moves paradoxically, with flail segment pulling in on inspiration and pushing out on expiration

Investigations - CXR, CT Chest

Management - Chest drain