Extrapleural hematoma after blunt chest trauma

Abstract text (incl. references and figure legends)

Case history

An 83-year-old male was admitted to the emergency room after a fall from a ladder, resulting in right shoulder and right hemithorax trauma. The patient was submitted to a chest CT scan that showed a right clavicle fracture, fracture of 7 ribs on the right and a right extrapleural hematoma, with a 65 mm diameter. Conservative management was applied.

Clinical findings

However, on the fifth day the patient had an exacerbation of the dyspnea and the pain.

Investigation/Results

Another chest CT scan revealed an increase of the extrapleural hematoma dimensions, 103 x 61 mm, with no evidence of active hemorraghe.

Diagnosis

Increasing of the extrapleural hematoma.

Therapy and Progressions

Due to hemodynamic stability the patient was transfered to the Thoracic Surgery Department and submitted to drainage of the hematoma.

Conclusion

An extrapleural hematoma is a rare and potentially life-threatening condition defined as the accumulation of blood in the extrapleural space between the parietal pleura and the endothoracic fascia. It usually happens after blunt thoracic trauma that causes fractures of the sternum or the ribs, which can tear the intercostal or internal mammary vessels and is sometimes mistaken for hemothorax. The conservative approach can be done of taking in consideration the patient hemodynamic status and the available resources.

References

M.A. Rashid et al.

Nomenclature, classification, and significance of traumatic extrapleural hematoma

J Trauma

(2000)

J.Y. Jeong et al.

Huge extrapleural hematoma by blunt trauma mimicking traumatic hemothora

J Trauma Acute Care Surg

(2012)

Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.)

No.