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Lungs and Pleura

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Acute Care Surgery

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Abstract

A 59-year-old patient with end-stage renal disease required direct placement of a central line that resulted in a pneumothorax and a hemothorax. Even after insertion of two chest tubes over a 48-hour period, there was still radiographic documentation of a substantial amount of retained hematoma. The patient is hemodynamically stable with a normal coagulation profile. Which of the following should be the management option?

  1. (A)

    Insertion of a third chest tube

  2. (B)

    Urokinase administration (via chest tube)

  3. (C)

    Video-assisted thoracic surgery

  4. (D)

    Thoracotomy

  5. (E)

    Continued observation

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, Harborview Medical Center, Seattle, WA, USA

    Riyad Karmy-Jones MD

  2. Department of Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA

    J. Wayne Meredith MD

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  1. Riyad Karmy-Jones MD
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Editor information

Editors and Affiliations

  1. Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA

    L. D. Britt MD, MPH (Brickhouse Professor of Surgery and Chairman) (Brickhouse Professor of Surgery and Chairman)

  2. Department of Surgery, Oregon Health Sciences University, Portland, OR, USA

    Donald D. Trunkey MD (Professor) (Professor)

  3. Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA

    David V. Feliciano MD (Professor of Surgery, Chief of Surgery) (Professor of Surgery, Chief of Surgery)

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Karmy-Jones, R., Meredith, J.W. (2007). Lungs and Pleura. In: Britt, L.D., Trunkey, D.D., Feliciano, D.V. (eds) Acute Care Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-69012-4_24

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  • DOI: https://doi.org/10.1007/978-0-387-69012-4_24

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-34470-6

  • Online ISBN: 978-0-387-69012-4

  • eBook Packages: MedicineMedicine (R0)

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