Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentPrognosisPrevention
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Prevention
A hemothorax is when there is an accumulation of blood between the membranes lining the lungs (thepleura). The most common cause is trauma, but lung infections, heart and lung surgery, cancer, or even excess doses of blood thinners may also be responsible.
When a hemothorax develops, there is often confusion at first because there are so many similarities in the symptoms of a hemothorax and other respiratory complications.
Prompt treatment of a hemothorax is important to reduce the risk of developing long-term respiratory problems like troubled breathing.
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Hemothorax Symptoms
Hemothorax symptoms can be difficult to distinguish from those of other conditions at first and may include:
Causes of a Hemothorax
There are many hemothorax causes. Depending on the cause, the blood may originate from the lungs, the heart, the chest wall, or the large blood vessels present in the chest. Some of these include:
IncidenceIt’s thought that close to 300,000 cases of hemothorax occur in the United States each year due to trauma alone, with chest injuries present in roughly 60% of patients with multiple trauma injuries.
Incidence
It’s thought that close to 300,000 cases of hemothorax occur in the United States each year due to trauma alone, with chest injuries present in roughly 60% of patients with multiple trauma injuries.
Risk Factors
Those with underlying conditions that include lung cancer, blood clotting defects, and tuberculosis are at an increased risk for a hemothorax as well.
A careful history may give some clues to the cause and presence of a hemothorax. On the side affected, lung sounds may be diminished or absent.
An upright chest X-raymay help to diagnose a hemothorax. A chest CT or further testing may then be considered. When a chest tube is placed, the fluid may be evaluated to confirm the presence of blood in the pleural cavity and further look for possible causes.
Differential Diagnoses
A hemothorax is different than some other conditions involving the thorax, such as:
Hemothorax Treatment
Initial treatment for a hemothorax usually involves stabilizing the person and theninserting a chest tube to drain the blood and airthat has built up or is building up between the lung membranes in thepleural cavity.
Often, a hemothorax is a result of blunt or penetrating trauma to the chest. When it occurs without trauma, it’s very important to find and treat the underlying cause.
Treatment usually involves inserting a chest tube as part of a video-assisted thoracostomy (a minimally invasive surgery in which small incisions are made in the chest and a surgery is done through these small incisions with the use of a camera).
For some people surgery, a thoracotomy (open chest surgery in contrast to minimally invasive surgery) is needed to get to the source and control the bleeding, especially in the setting of large hemothorax or when the source of the bleeding is uncertain.
For people who sustain a hemothorax as a result of chest trauma, the overall prognosis is actually quite good, and excellent if the hemothorax can be adequately treated.
Prognosis may also be good when the hemothorax occurs as a complication of a biopsy or chest surgery.
When a hemothorax occurs in the presence of cancer (due to growth of the tumor through the lung lining) or a pulmonary infarct, however, the prognosis is more guarded.
Complications After Treatment
For those people who receive treatment, a small number are left with anempyema(a collection of pus between the membranes lining the lungs) or some scarring of the pleura (pleural fibrosis).
With an empyema, further surgeries may be done to remove the pus and to prevent further fluid and bacteria from entering the chest.
Treatments for fibrosis are primarily supportive as fibrosis is usually irreversible. That said, treatments ranging from pulmonary rehabilitation to breath training can be helpful in restoring the best quality of life possible.
Fibrosis may result in long-term respiratory symptoms for some people.
Depending on the cause, a hemothorax may or may not be preventable. Since trauma is the most common cause, taking safety measures when doing activities may decrease the chance of trauma to the chest. Examples include wearing a seat belt when driving or wearing chest protection garments if involved in contact sports.
Additionally, a hemothorax may occur from lung cancer, and it’s known that smoking tobacco is the leading cause of lung cancer.Smoking cessationcan decrease the risk of developing lung cancer which reduces the chance of complications of lung cancer, such as a hemothorax.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.U.S. National Library of Medicine, MedlinePlus.Hemothorax.Patrini D, Panagiotopoulos N, Pararajasingham J, Gvinianidze L, Iqbal Y, Lawrence DR.Etiology and management of spontaneous haemothorax.J Thorac Dis. 2015;7(3):520–526. doi:10.3978/j.issn.2072-1439.2014.12.50Mowery NT, Gunter OL, Collier BR, et al.Practice management guidelines for management of hemothorax and occult pneumothorax.J Trauma. 2011;70(2):510-518. doi:10.1097/TA.0b013e31820b5c31Shoar S, Hosseini FS, Naderan M, et al.Cardiac injury following blunt chest trauma: diagnosis, management, and uncertainty.Int J Burns Trauma. 2021;11(2):80-89.Beaudoin S, Gonzalez AV.Evaluation of the patient with pleural effusion.CMAJ. 2018;190(10):E291-E295. doi:10.1503/cmaj.170420University of Michigan, Michigan Medicine.Pleural diseases.Tanizaki S, Maeda S, Sera M, et al.Small tube thoracostomy (20-22 Fr) in emergent management of chest trauma.Injury. 2017;48(9):1884-1887. doi:10.1016/j.injury.2017.06.021American Cancer Society.What causes lung cancer?.Additional ReadingAktas, A., Gozlek, E., Yazkan, R. et al.Transthoracic Biopsy of Lung Masses: Non-Technical Factors Affecting Complication Occurrence.Thoracic Cancer. 6(2):151-8.Morgan, C., Bashoura, L., Balachndran, D., and A. Saadia.Spontaneous Hemothorax.Annals of the American Thoracic Society. 12(10):1578-1582.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.U.S. National Library of Medicine, MedlinePlus.Hemothorax.Patrini D, Panagiotopoulos N, Pararajasingham J, Gvinianidze L, Iqbal Y, Lawrence DR.Etiology and management of spontaneous haemothorax.J Thorac Dis. 2015;7(3):520–526. doi:10.3978/j.issn.2072-1439.2014.12.50Mowery NT, Gunter OL, Collier BR, et al.Practice management guidelines for management of hemothorax and occult pneumothorax.J Trauma. 2011;70(2):510-518. doi:10.1097/TA.0b013e31820b5c31Shoar S, Hosseini FS, Naderan M, et al.Cardiac injury following blunt chest trauma: diagnosis, management, and uncertainty.Int J Burns Trauma. 2021;11(2):80-89.Beaudoin S, Gonzalez AV.Evaluation of the patient with pleural effusion.CMAJ. 2018;190(10):E291-E295. doi:10.1503/cmaj.170420University of Michigan, Michigan Medicine.Pleural diseases.Tanizaki S, Maeda S, Sera M, et al.Small tube thoracostomy (20-22 Fr) in emergent management of chest trauma.Injury. 2017;48(9):1884-1887. doi:10.1016/j.injury.2017.06.021American Cancer Society.What causes lung cancer?.Additional ReadingAktas, A., Gozlek, E., Yazkan, R. et al.Transthoracic Biopsy of Lung Masses: Non-Technical Factors Affecting Complication Occurrence.Thoracic Cancer. 6(2):151-8.Morgan, C., Bashoura, L., Balachndran, D., and A. Saadia.Spontaneous Hemothorax.Annals of the American Thoracic Society. 12(10):1578-1582.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
U.S. National Library of Medicine, MedlinePlus.Hemothorax.Patrini D, Panagiotopoulos N, Pararajasingham J, Gvinianidze L, Iqbal Y, Lawrence DR.Etiology and management of spontaneous haemothorax.J Thorac Dis. 2015;7(3):520–526. doi:10.3978/j.issn.2072-1439.2014.12.50Mowery NT, Gunter OL, Collier BR, et al.Practice management guidelines for management of hemothorax and occult pneumothorax.J Trauma. 2011;70(2):510-518. doi:10.1097/TA.0b013e31820b5c31Shoar S, Hosseini FS, Naderan M, et al.Cardiac injury following blunt chest trauma: diagnosis, management, and uncertainty.Int J Burns Trauma. 2021;11(2):80-89.Beaudoin S, Gonzalez AV.Evaluation of the patient with pleural effusion.CMAJ. 2018;190(10):E291-E295. doi:10.1503/cmaj.170420University of Michigan, Michigan Medicine.Pleural diseases.Tanizaki S, Maeda S, Sera M, et al.Small tube thoracostomy (20-22 Fr) in emergent management of chest trauma.Injury. 2017;48(9):1884-1887. doi:10.1016/j.injury.2017.06.021American Cancer Society.What causes lung cancer?.
U.S. National Library of Medicine, MedlinePlus.Hemothorax.
Patrini D, Panagiotopoulos N, Pararajasingham J, Gvinianidze L, Iqbal Y, Lawrence DR.Etiology and management of spontaneous haemothorax.J Thorac Dis. 2015;7(3):520–526. doi:10.3978/j.issn.2072-1439.2014.12.50
Mowery NT, Gunter OL, Collier BR, et al.Practice management guidelines for management of hemothorax and occult pneumothorax.J Trauma. 2011;70(2):510-518. doi:10.1097/TA.0b013e31820b5c31
Shoar S, Hosseini FS, Naderan M, et al.Cardiac injury following blunt chest trauma: diagnosis, management, and uncertainty.Int J Burns Trauma. 2021;11(2):80-89.
Beaudoin S, Gonzalez AV.Evaluation of the patient with pleural effusion.CMAJ. 2018;190(10):E291-E295. doi:10.1503/cmaj.170420
University of Michigan, Michigan Medicine.Pleural diseases.
Tanizaki S, Maeda S, Sera M, et al.Small tube thoracostomy (20-22 Fr) in emergent management of chest trauma.Injury. 2017;48(9):1884-1887. doi:10.1016/j.injury.2017.06.021
American Cancer Society.What causes lung cancer?.
Aktas, A., Gozlek, E., Yazkan, R. et al.Transthoracic Biopsy of Lung Masses: Non-Technical Factors Affecting Complication Occurrence.Thoracic Cancer. 6(2):151-8.Morgan, C., Bashoura, L., Balachndran, D., and A. Saadia.Spontaneous Hemothorax.Annals of the American Thoracic Society. 12(10):1578-1582.
Aktas, A., Gozlek, E., Yazkan, R. et al.Transthoracic Biopsy of Lung Masses: Non-Technical Factors Affecting Complication Occurrence.Thoracic Cancer. 6(2):151-8.
Morgan, C., Bashoura, L., Balachndran, D., and A. Saadia.Spontaneous Hemothorax.Annals of the American Thoracic Society. 12(10):1578-1582.
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