Management of Retained Traumatic Hemothorax

Abstract

Hemothorax is a common problem following both blunt and penetrating trauma. The majority of hemothoraces can be managed by simple tube thoracostomy placed on admission to the hospital. However, for up to 5% of patients who present with either traumatic hemothorax or hemo-pneumothorax, tube thoracostomy fails to completely decompress the entire hemothorax. Left untreated a retained hemothorax can lead to fibrothorax, entrapped lung or empyema. It is in this minority of patients who are otherwise hemodynamically stable that great controversy in surgical management exists.