Management of Traumatic Hemothorax a Retrospective Study of 165 Cases in AL-Jamhoori Teaching Hospital in Mosul

Abstract

ABSTRACT:BACKGROUND:Traumatic hemothorax is one of the most common thoracic injuries in the world. There are a lot ofdebates about the best method of management because of the possible risk of death anddevelopment of subsequent complications.OBJECTIVE:The objective of this study is to decide the best type of management of traumatic hemothorax(thoracostomy tube drainage versus thoracotomy) for life saving and prevention of subsequentcomplications such as trapped lung with fibrothorax, and empyema.METHODS:This is a retrospective study of 165 consecutive patients with traumatic hemothorax admitted toAl-Jamhoori teaching hospital in Mosul from 1st January 2010 to 1st January 2012. The parametersthat were used in this study were sex, age group, mechanism of injury, hemodynamic state at timeof according to volume of blood in the drainage bottle into5 groups. The patients were alsoclassified into 4 groups depending on their hemodynamic state at time of presentation.RESULTS:Thoracostomy tube drainage was done in the majority of cases as the mainstay of treatment, inminority of cases it was followed by thoracotomy for those with massive hemothorax, severehypovolemic shock, associated thoracic injuries, or those with complications.CONCLUSION:Traumatic hemothorax should be treated initially by thoracostomy tube drainage except in veryurgent cases, and the decision for thoracotomy should be based on the hemodynamic state, thevolume of drained blood and the presence of associated thoracic injuries. A good initial care andproper drainage of collected intrathoracic blood reduces the development of late complications andthe subsequent need for thoracotomy..