A Case Report of Delayed Hemothorax Complicated by Fibrothorax

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A Case Report of Delayed Hemothorax Complicated by Fibrothorax

Tanvi Chokshi1, Alexandra Theodosopoulos1, Ethan Wilson1, Michael Ysit1, Sameir Alhadi2, Leonard Ranasinghe3*
1Second year medical students, California Northstate University, Elk Grove, California, USA
2Director of Emergency Department and Emergency Medicine Clerkship Site Director, St. Agnes Medical
Center
, Fresno, California, USA

3Professor and Emergency Medicine Clerkship Director, California Northstate University, Elk Grove,
California, USA

Corresponding Author: Leonard Ranasinghe, MD
Address: College of Medicine, California Northstate University, 9700 West Taron Drive Elk Grove, California 95757, USA.
Received date: 26 September 2021; Accepted date: 25 October 2021; Published date: 02 November 2021

Citation: Chokshi T, Theodosopoulos A, Wilson E, Ysit M, Alhadi S, Ranasinghe L. A Case Report of Delayed Hemothorax Complicated by Fibrothorax. Asp Biomed Clin Case Rep. 2021 Nov 02;4(3):184-90.

Copyright © 2021 Chokshi T, Theodosopoulos A, Wilson E, Ysit M, Alhadi S, Ranasinghe L. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.

Keywords: Delayed Hemothorax, Chest Wall Trauma, Rib Fractures, Fibrothorax, Open Thoracotomy

Abstract

Delayed hemothorax is a potentially life-threatening complication of thoracic trauma that should be carefully considered in all patients presenting with thoracic injury. We report a case of delayed hemothorax in a 77-year-old male presenting eleven days’ status post multiple right mid- to high-rib fractures. His case was complicated by retained hemothorax after CT-guided chest-tube with subsequent video-assisted tube thoracostomy (VATS) revealing fibrothorax necessitating conversion to open thoracotomy. Known risk factors for development of delayed hemothorax include older patient age, three or more rib fractures, and presence of mid- to high-rib fractures, and should be used in risk stratification of thoracic trauma. Tube thoracostomy is often sufficient in management of delayed hemothorax. In rare cases, hemothoraces can be complicated by retained hemothorax or fibrothorax, which require more invasive therapy and carry greater morbidity and mortality.