Mendez JIA, Velázquez-Rivera AD, Sanabria-Cordero D, Trejo-Rosas S, Avalos-García M, Galindo-López P

Language: Spanish
References: 9
Page: 50-54
PDF size: 336.70 Kb.

ABSTRACT

Late massive hemothorax is a potentially life-threatening surgical emergency. Our objective is to present the clinical case of a 31-yearold male patient who entered the emergency department with blunt chest trauma, which manifested 14 hours after the onset of hemodynamic instability with hypotension, tachycardia and dyspnea. When taking the chest x-ray with evidence of a left hemothorax which was corroborated by ultrasound and tomography, therefore, an endopleural tube was placed, reporting an initial expenditure of 1,500 mL, moving to the operating room where they reported a total bleeding of 4,500 mLsecondary to injury. of the triangular ligament of the left pulmonary with a solution of continuity of the parietal pleura of approximately 5 cm in length. In this case report we will analyze the pathophysiology, initial evaluation, diagnosis and treatment in patients with late massive hemothorax.

REFERENCES

1. Cortes-Telles A, Morales-Villanueva C, Figueroa-Hurtado E.Hemotórax: etiología, diagnóstico, tratamiento y complicaciones.REVISTA BIOMÉDICA. 2016; 27(3). doi:https://doi.org/10.32776/revbiomed.v27i3.540

2. González LR, Riquelme UA, Toloza AC, Reyes MR, SeguelSE, Stockins LA, et al. Hemotórax masivo por traumatismotorácico en pacientes tratados quirúrgicamente. Rev. cir.[Internet]. 2020 Oct [citado 2024 Abr 13] ; 72( 5 ): 434-440.Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S2452-45492020000500434&lng=es. http://dx.doi.org/10.35687/s2452-45492020005655

3. Chan Hee Park, Kyeong Eui Kim, Min Cheol Chae, Jeong WooLee, Hemotórax masivo retrasado después de un traumatismo torácicocerrado que requirió toracotomía mediante VATS: informede un caso, Journal of Surgical Case Reports. 2022, número 1,enero de 2022, rjab537, https //doi.org/10.1093/jscr/rjab537

4. Chang SW, Ryu KM, Ryu JW. Delayed massive hemothorax requiringsurgery after blunt thoracic trauma over a 5-year period: complicatingrib fracture with sharp edge associated with diaphragminjury. Clinical and experimental emergency medicine. 2018; 5(1),60–65. https://doi.org/10.15441/ceem.16.190

5. Morley EJ, Johnson S, Leibner E, Shahid J. Evaluación y tratamientodel traumatismo cerrado de tórax y pulmón (Trauma CME)en el departamento de urgencias. Práctica médica emergente.2016 junio; 18 (6):1-20.

6. Chou YP, Lin HL, Wu TC. Cirugía toracoscópica videoasistidapara hemotórax retenido en traumatismo torácico cerrado. Opiniónactual Pulm Med. 2015 julio; 21 (4): 393-8.

7. Ota K, Fumimoto S, Iida R, Kataoka T, Ota K, Taniguchi K, HanaokaN, Takasu A. Massive hemothorax due to two bleedingsources with minor injury mechanism: a case report. J Med CaseRep. 2018 octubre 07; 12(1):291

8. Igai H, Kamiyoshihara M, Yoshikawa R, Ohsawa F, Yazawa T.Delayed massive hemothorax due to a diaphragmatic lacerationcaused by lower rib fractures. Gen Thorac Cardiovasc Surg. 2019;67:811–3.

9. ATLS - Advanced trauma life support, 10º edition. Chicago, Ill.:American College of Surgeons, Committee on Trauma, 2018.