Accumulation of blood in the pleural space is a hemothorax
Hemothorax is a bleeding inside the pleural cavity of lung and large intrathoracic vessels. Bleeding occurs as a result of injury to the chest or as a result of complications of treatment. The congestion of blood in the pleural cavity indicates respiratory failure. Then may be followed by hemorrhagic shock and death. In the diagnosis of hemothorax, the patient needed emergency care.
Causes of hemorrhage
The causes of hemorrhage can be divided into three main groups 1) traumatic, 2) pathological 3) iatrogenic.
The most common cause of hemothorax is closed or open injury in which damaged bone frame. Injury to the chest may be a result of road traffic accidents, bullet wounds, broken ribs, stab wound, fall from a height and other thoracic injuries.
According to statistics, almost 70% of all cases the bleeding occurs from the right side. In the pleural region begins to accumulate in the blood due to internal injuries, intercostal or joints of the aorta.
Another less common cause of hemothorax is a consequence of severe illness. These include: tuberculosis, lung cancer or pleural, aortic aneurysm (rupture), benign or malignant tumors in the chest, hemorrhagic diabetes, lung infarction, coagulopathy (poor blood clotting).
Also hemorrhage in the pleural area may occur during operations on the lungs or pleura. In some cases, the injury can be obtained when carrying out medical or diagnostic procedures, for example, pleural puncture or installation of the catheter. The causes of hemothorax is called iatrogenic.
What is a hemothorax
Depending on the number and places of a congestion of blood hemothorax divided as follows.
- Total or large. Occurs when the pleural region with blood.
- Apical: bleeding occurs in the upper part of the lung.
- Small: blood does not rise above the level of the angle of the scapula.
- Interlobar: hemorrhage and accumulation of blood occurs in the interlobar fissures.
- Nudepregnancy: hemorrhage and accumulation of blood occurs in the place fit the diaphragm to the pleural region.
- Summany: blood is limited to adhesions in the pleural region.
- Paramedicales: blood fills the pleural region in placefit with the mediastinum.
- Clotted hemothorax (after the haemorrhage blood clotting).
The severity of hemothorax depends on the degree of tightness of the internal organs of blood, which fills the pleural area; the amount of blood streamed; the magnitude of blood loss; the presence of join the bleeding infection.
Symptoms of hemothorax
Clinical manifestations of hemothorax will depend on the severity of the injury, the amount poured into the pleural cavity of blood, tightness of the lungs and other organs.
With a small hemothorax symptoms are mild. The victim may complain of pain in the chest, which are aggravated by coughing. Also, the patient is experiencing a little shortness of breath. When the hemorrhage is large or the average size, the victim is experiencing severe pain, even during quiet breathing. In addition to the area that was bleeding, the pain may spread to the back or shoulder. Additional symptoms of such a hemothorax is a feeling of weakness, shallow breathing and a drop in blood pressure. Without proper treatment symptoms worse.
The patient can't for a long time to be in a horizontal position and perform any physical activity as the pain syndrome increases. In severe cases the victim is observed pale skin, chest pain, dizziness and disruption of the heart muscle (tachycardia).
Possible fainting. Severe form leads to anemia. If the result of the injury was a fracture of the ribs, formed a hematoma of soft tissues, and in the event of a puncture a lung from a patient's cough with hemoptysis.
Curled up in the pleural region of the blood causes severe pain and disturbance of the breathing process.
The blood starts clotting, which leads to a sclerotic process in the lung, i.e., tissue death. When hemothorax complicated by infection, there are fever, General weakness and intoxication.
Regardless of the severity of hemothorax, it is obvious signs are a violation of the process of breathing and pain in sternum. To make the correct diagnosis and determine the seriousness of the situation, the patient prescribed x-ray or a CT scan. Such diagnostics allows to detect not only the presence of hemorrhage, but also its causes. To exclude the presence of a pathological environment (bacteria and fungi) make puncture of blood that flows into the pleuralarea.
Treatment of hemothorax
If you experience signs of hemorrhage the casualty should be sent immediately to a specialized medical facility for a complete diagnosis. The success of treatment will depend on how fast was diagnosed with the disease.
Regardless of the severity of the damage, seek medical assistance it is mandatory. Late treatment of severe can lead to death of the patient.
The method of treatment will depend on severity of the hemothorax and the existence of other individual patient.
First aid to the victim prior to his hospital admission consists of the application of painkillers. If you suspect a hypovolemic shock patient impose tight bandage, which is moistened with anesthetic, provide oxygen and put on a drip to improve capillary blood flow (reopoliglyukin).
With a slight hemorrhage, that is, with a small hemothorax may be assigned to conservative treatment. It involves the use of antibiotics and anti-inflammatory drugs. A small amount of blood, poured out in the pleural region, is not required drainage. With proper treatment, the human body dissolves the liquid. The therapy is carried out under strict radiological control. It can last from two weeks to a month.
When a large hemorrhage is drainage.
Surgical intervention is needed when the patient curled up form of hemothorax or serious internal injuries.
If the victim has signs of damage to major blood vessels or of the aorta, surgery may be carried out urgently at the scene of thoracic surgery.