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Different Radiographic Representation Of Hemothorax: It's Manifestation As Seen On The X-ray

Updated on February 7, 2014

X-Ray Diagnostics

Source

Introduction

Hemothorax is as a result of Trauma to the chest cavity or thoracic region. When this occurs, the pleural space may experience some tear and hence the presence of blood in it. The source of blood could be from any part of the thoracic region be it vessels, the heart, chest wall or the lung parenchyma itself.

Treatment is only done through surgery and this procedure is called, tube thoracostomy. A tube is inserted into the pleural to remove the blood accumulated in it. When inserted, the lungs expand and the bleeding stops. Sometimes, the blood accumulated may clot and result to what is known as retained hemothorax. In such a situation, highly functional tubes are used to remove the blood.

This hub serves to show pictorial representations (On X-ray) only as there are already lots of articles around the web which talk about hemothorax. This situation is an emergency one which can be treated only via surgery.

Hemothorax On X-ray

Although some authors state that a hematocrit value of at least 50% is necessary to differentiate a hemothorax from a bloody pleural effusion, most do not agree on any specific distinction.
Although some authors state that a hematocrit value of at least 50% is necessary to differentiate a hemothorax from a bloody pleural effusion, most do not agree on any specific distinction. | Source
Hemothorax is usually a consequence of blunt or penetrating trauma. Much less commonly, it may be a complication of disease, may be iatrogenically induced, or may develop spontaneously.
Hemothorax is usually a consequence of blunt or penetrating trauma. Much less commonly, it may be a complication of disease, may be iatrogenically induced, or may develop spontaneously. | Source
Prompt identification and treatment of traumatic hemothorax is an essential part of the care of the injured patient. The upright chest radiograph is the ideal primary diagnostic study in the evaluation of hemothorax
Prompt identification and treatment of traumatic hemothorax is an essential part of the care of the injured patient. The upright chest radiograph is the ideal primary diagnostic study in the evaluation of hemothorax | Source
In cases of hemothorax unrelated to trauma, a careful investigation for the underlying source must be performed while treatment is provided.
In cases of hemothorax unrelated to trauma, a careful investigation for the underlying source must be performed while treatment is provided. | Source
Tube thoracostomy drainage is the primary mode of treatment. Video-assisted thoracoscopic surgery (VATS) may be used. Thoracotomy is the procedure of choice for surgical exploration of the chest when massive hemothorax or persistent bleeding is prese
Tube thoracostomy drainage is the primary mode of treatment. Video-assisted thoracoscopic surgery (VATS) may be used. Thoracotomy is the procedure of choice for surgical exploration of the chest when massive hemothorax or persistent bleeding is prese | Source
Normally, the pleural space, which is between the parietal and visceral pleurae, is only a potential space. Bleeding into the pleural space may result from either extrapleural or intrapleural injury.
Normally, the pleural space, which is between the parietal and visceral pleurae, is only a potential space. Bleeding into the pleural space may result from either extrapleural or intrapleural injury. | Source
Traumatic disruption of the chest wall tissues with violation of the pleural membrane can cause bleeding into the pleural cavity. The most likely sources of significant or persistent bleeding from chest wall injuries are the intercostal and internal
Traumatic disruption of the chest wall tissues with violation of the pleural membrane can cause bleeding into the pleural cavity. The most likely sources of significant or persistent bleeding from chest wall injuries are the intercostal and internal | Source
internal mammary arteries. In nontraumatic cases, rare disease processes within the chest wall (eg, bony exostoses) can be responsible. Blunt or penetrating injury involving virtually any intrathoracic structure can result in hemothorax.
internal mammary arteries. In nontraumatic cases, rare disease processes within the chest wall (eg, bony exostoses) can be responsible. Blunt or penetrating injury involving virtually any intrathoracic structure can result in hemothorax. | Source
Massive hemothorax or exsanguinating hemorrhage may result from injury to major arterial or venous structures contained within the thorax or from the heart itself.
Massive hemothorax or exsanguinating hemorrhage may result from injury to major arterial or venous structures contained within the thorax or from the heart itself. | Source
These include the aorta and its brachiocephalic branches, the main or branch pulmonary arteries, the superior vena cava and the brachiocephalic veins, the inferior vena cava, the azygous vein, and the major pulmonary veins.
These include the aorta and its brachiocephalic branches, the main or branch pulmonary arteries, the superior vena cava and the brachiocephalic veins, the inferior vena cava, the azygous vein, and the major pulmonary veins. | Source
Injury to the heart can produce a hemothorax if a communication exists between the pericardium and the pleural space. Injury to the pulmonary parenchyma may cause hemothorax, but it is usually self-limited because pulmonary vascular pressure is norma
Injury to the heart can produce a hemothorax if a communication exists between the pericardium and the pleural space. Injury to the pulmonary parenchyma may cause hemothorax, but it is usually self-limited because pulmonary vascular pressure is norma | Source
Pulmonary parenchymal injury is usually associated with pneumothorax and results in limited hemorrhage. Hemothorax resulting from metastatic malignant disease is usually from tumor implants that seed the pleural surfaces of the thorax.
Pulmonary parenchymal injury is usually associated with pneumothorax and results in limited hemorrhage. Hemothorax resulting from metastatic malignant disease is usually from tumor implants that seed the pleural surfaces of the thorax. | Source
Diseases of the thoracic aorta and its major branches, such as dissection or aneurysm formation, account for a large percentage of specific vascular abnormalities that can cause hemothorax.
Diseases of the thoracic aorta and its major branches, such as dissection or aneurysm formation, account for a large percentage of specific vascular abnormalities that can cause hemothorax. | Source
Aneurysms of other intrathoracic arteries such as the internal mammary artery have been described and are possible causes of hemothorax if rupture occurs.
Aneurysms of other intrathoracic arteries such as the internal mammary artery have been described and are possible causes of hemothorax if rupture occurs. | Source
A variety of unusual congenital pulmonary abnormalities, including intralobar and extralobar sequestration, hereditary telangiectasia, and congenital arteriovenous malformations, can cause hemothorax.
A variety of unusual congenital pulmonary abnormalities, including intralobar and extralobar sequestration, hereditary telangiectasia, and congenital arteriovenous malformations, can cause hemothorax. | Source
Hemothorax can result from a pathologic process within the abdomen if blood escaping from the lesion is able to traverse the diaphragm through one of the normal hiatal openings or a congenital or acquired opening.
Hemothorax can result from a pathologic process within the abdomen if blood escaping from the lesion is able to traverse the diaphragm through one of the normal hiatal openings or a congenital or acquired opening. | Source
Blunt chest trauma can occasionally result in hemothorax by laceration of internal vessels. Because of the relatively more elastic chest wall of infants and children, rib fractures may be absent in such cases
Blunt chest trauma can occasionally result in hemothorax by laceration of internal vessels. Because of the relatively more elastic chest wall of infants and children, rib fractures may be absent in such cases | Source

References

1. All X-ray photos here are from DFM E-Group, in the photo and X-ray section.

2. Notes and explanations: Wikipedia, Essentials of Clinical Medicine by Kumar and Clark's, Medicinenet and Mayor's Clinic.

© 2014 Funom Theophilus Makama

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