Management of Traumatic Hemothorax, Retained Hemothorax, and Other Thoracic Collections

Abstract

Purpose of Review

This review focuses on the various approaches for the treatment of post-traumatic hemothorax, retained hemothorax, and other thoracic collections.

Recent Findings

Early diagnosis and complete evacuation of post-traumatic hemothorax are essential to avoid complications. Incomplete evacuation of blood may result in retained hemothorax, fibrothorax, or empyema. Tube thoracostomy has been the most commonly used option for draining blood and other collections. Alternative options include image-guided placement of small-bore chest tubes, video-assisted thoracoscopic surgery (VATS), and thoracotomy. However, as data supporting safety and efficacy of image-guided placement of small-bore chest tubes have been increasingly published, the technique has been widely adopted as a primary treatment option for patients with various pleural collections after trauma.

Summary

Traumatic pleural collections have traditionally been treated with tube thoracostomy, VATS, or thoracotomy. However, recent data suggest that placement of small-bore chest tubes is similarly effective with a reduced rate of complication and should be considered as a viable option.

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