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Spontaneous hemopneumothorax: experience with early surgical management of two clinics

Yıl 2019, , 450 - 454, 30.06.2019
https://doi.org/10.7197/223.vi.509426

Öz

Objective: SHP
is an uncommon clinical disorder that is potentially life threatening due to
rapid lung collapse and blodd loss into pleural cavity. . Early surgical
internention for SHP is a life saving procedure, and avoids complications such
as atelectasis, restrictive lung disorders, infection of residual hematoma and
reduce the incidence of delayed surgical exploration and decortication. We
herein report a retrospective study in order to evaluate our demographic
records, intraoperative findings, surgical methods and clinical experience of
early surgery.

Method: We
initially included all patients with primary spontaneous pneumothorax attending
the clinics of Dicle University Faculty of Medicine, Diyarbakir, Turkey and
Cukurova UniversityFaculty of Medicine, Adana, Turkey. From June 2003 and
December 2018, a total of 802 patients were diagnosed as spontaneous
pneumothorax. After thoracocentesis, twenty four of them were diagnosed with
SHP of whom sixteen underwent an prompt thoracotomy or VATS. We retrospectively
collected demographic characteristics, clinical presentations, admitting time
intervals, initial chest tube drainage, surgical strategies, intraoperative
findings and medical history for all SHP patients.

Results: Female / Male ratio was 1/23. Ranging
in age from 16 to 54 years (mean age, 25,6 years). Five patients were underwent
urgent operation because of hypovolemic shock and amount of blood drainage.
Other 11 patients were underwent operation within 24 hours. Ten patients
underwent thoracotomy, and 6 underwent VATS. Remain 8 patients were treated
with tube thoracostomy. During the operations, source of hemorrhage was
detected; apical abberant vessel in 7 patients, torn of parietal pleura in 6
patients and ruptured vascularized bullae/lung parenchyma in 3 patients. No
recurrence of SHP occured with these 24 patients during the follow-up period.







Conclusions:
Early
surgery should be performed in patients who are hemodynamically unstable or
continuous bleeding from pleural drain. Both, VATS and minithoracotomy are
appropriate tecniques for surgery.

Kaynakça

  • Referans1. Abyholm EE, Storen G. Spontaneous haemopneumothorax. Thorax 1973; 28: 376-7.
  • Referans2. Tatebe Sh, Kanazawa H, Yamazaki Y, Aoki E, Sakurai Y. Spontaneous hemopneumothorax. Ann Thorac Surg 1996; 62: 1011-5.
  • Referans3. Rowell NR. Spontaneous haemopneumothorax. Br J Tuberc 1956; 50: 214-20.
  • Referans4. Wu YC, Lu MS, Yeh CH, et al. Justifying video-assisted thoracic surgery for spontaneous hemopneumothorax. Chest 2002; 122: 1844-7.
  • Referans5. Chiang WC, Chen WJ, Chang KJ, Lai TI, Yuan A. Spontaneous hemopneumothorax: an overlooked lifethreatening condition. Am J Emerg Med 2003; 21: 343–5.
  • Referans6. Ali HA, Lippmann M, Mundathaje U, Khaleeq G. Spontaneous hemothorax: a comprehensive review. Chest 2008; 134: 1056–65.Referans7. Kurimoto Y, Hatamoto K, Hase M, Narimatsu E, Asai Y, Abe T. Aberrant artery as a source of bleeding in spontaneous hemopneumothorax. Am J Emerg Med 2001; 19: 326-7.
  • Referans8. Kim ES, Kang JY, Pyo CH, Jeon EY, Lee WB. 12-year experience of spontaneous hemopneumothorax. Ann Thorac Cardiovasc Surg 2008; 14: 149-53.
  • Referans9. De Perrot M, Deieaval J, Robert J, Spiliopoulos A. Spontaneous Hemopneumothorax –results of concervative treatment. Swiss Surg 2000; 6: 62-4.
  • Referans10. Hsu NY, Shih CS, Hsu CP, Chen PR. Spontaneous hemopneumothorax revisited: Clinical approach and systemic review of the literatüre. Ann Thorac Surg 2005; 80: 1859-63.
Yıl 2019, , 450 - 454, 30.06.2019
https://doi.org/10.7197/223.vi.509426

Öz

Kaynakça

  • Referans1. Abyholm EE, Storen G. Spontaneous haemopneumothorax. Thorax 1973; 28: 376-7.
  • Referans2. Tatebe Sh, Kanazawa H, Yamazaki Y, Aoki E, Sakurai Y. Spontaneous hemopneumothorax. Ann Thorac Surg 1996; 62: 1011-5.
  • Referans3. Rowell NR. Spontaneous haemopneumothorax. Br J Tuberc 1956; 50: 214-20.
  • Referans4. Wu YC, Lu MS, Yeh CH, et al. Justifying video-assisted thoracic surgery for spontaneous hemopneumothorax. Chest 2002; 122: 1844-7.
  • Referans5. Chiang WC, Chen WJ, Chang KJ, Lai TI, Yuan A. Spontaneous hemopneumothorax: an overlooked lifethreatening condition. Am J Emerg Med 2003; 21: 343–5.
  • Referans6. Ali HA, Lippmann M, Mundathaje U, Khaleeq G. Spontaneous hemothorax: a comprehensive review. Chest 2008; 134: 1056–65.Referans7. Kurimoto Y, Hatamoto K, Hase M, Narimatsu E, Asai Y, Abe T. Aberrant artery as a source of bleeding in spontaneous hemopneumothorax. Am J Emerg Med 2001; 19: 326-7.
  • Referans8. Kim ES, Kang JY, Pyo CH, Jeon EY, Lee WB. 12-year experience of spontaneous hemopneumothorax. Ann Thorac Cardiovasc Surg 2008; 14: 149-53.
  • Referans9. De Perrot M, Deieaval J, Robert J, Spiliopoulos A. Spontaneous Hemopneumothorax –results of concervative treatment. Swiss Surg 2000; 6: 62-4.
  • Referans10. Hsu NY, Shih CS, Hsu CP, Chen PR. Spontaneous hemopneumothorax revisited: Clinical approach and systemic review of the literatüre. Ann Thorac Surg 2005; 80: 1859-63.
Toplam 9 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Surgical Science Research Makaleler
Yazarlar

Alper Avcı 0000-0001-9337-3030

Serdar Onat

Refik Ülkü

Cemal Özçelik 0000-0001-7654-5523

Yayımlanma Tarihi 30 Haziran 2019
Kabul Tarihi 29 Haziran 2019
Yayımlandığı Sayı Yıl 2019

Kaynak Göster

AMA Avcı A, Onat S, Ülkü R, Özçelik C. Spontaneous hemopneumothorax: experience with early surgical management of two clinics. CMJ. Haziran 2019;41(2):450-454. doi:10.7197/223.vi.509426