Ýzole travmatik hemotorakslara klinik yaklaþým

The clinical approach to the isolated traumatic hemothorax

BACKGROUND: The aim of this study was to evaluate the systematic approach to the isolated traumatic hemothorax. MATERIAL AND METHODS: The treatment modalities of 103 cases with isolated hemothorax was analyzed retrospectively between 1995 and 2003. RESULTS: We observed 103 isolated hemothorax cases. Eighty eight of them were male and 15 were female. The mean age was 39.4 years. The hemothorax was left sided at 41 cases, right sided at 60 cases and bilateral at 2 cases. Fifty three (51,4%) penetrating, forty nine (47,5%) blunt, and one (0,9%) iatrogenic traumas with resultant hemothoraxes were investigated. We performed tube thoracostomy in ninety nine cases. One case required an urgent thoracotomy. We operated twenty one cases and thoracoscopy was performed for six of them. The conservative approach was sufficient for eighty two patients. Mortality was seen in only one case (0,9%), because of a multiorgan failure. The mean rate of the hospital stay was 8,7 days. During operation, we explored for major pulmonary and systemic artery injury. CONCLUSIONS: The decision of exploration or conservative treatment must be made according to the patient stabilization status after the thoracostomy tube insertion. Thoracoscopic evacuation of blood clots from hemothoraxes must be attempted during the early posttraumatic stages, especially in cases refractory to classical drainage methods.