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Successful thoracoscopic evacuation of an extrapleural hematoma with delayed symptomatic pleural effusion: a case report.
Surg Case Rep 2019; 5(1):133SC

Abstract

BACKGROUND

Traumatic extrapleural hematoma is a rare condition and is usually managed conservatively until spontaneous resolution unless active bleeding or expansion is found.

CASE PRESENTATION

An 80-year-old man taking an anticoagulant medication was referred to our hospital after accidentally falling in a street ditch while riding a bike. Chest X-ray and computed tomography (CT) scan showed multiple fractures on ribs 7-9, hemothorax, and extrapleural hematoma in the posterior chest wall. Though the patient's hemothorax was improved by chest tube drainage, the extrapleural hematoma still remained. He was transferred to another hospital for rehabilitation, but he was readmitted to our hospital because of dyspnea with accumulation of left pleural effusion, including a subpopulation of neutrophils, but without bacterial infection. We performed thoracoscopic evacuation of the hematoma on day 57 after the initial blunt chest trauma. The patient has had no recurrence of pleuritis for 6 months after surgery.

CONCLUSION

Since posttraumatic extrapleural hematoma may result in delayed secondary intractable pleural effusion causing dyspnea, careful observation is necessary when considering indications of surgical intervention.

Authors+Show Affiliations

Division of Thoracic Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan. mshimomu@koto.kpu-m.ac.jp.Division of Thoracic Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan.Department of General Thoracic Surgery, Ayabe City Hospital, Ayabe, Japan.Division of Thoracic Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31414255

Citation

Shimomura, Masanori, et al. "Successful Thoracoscopic Evacuation of an Extrapleural Hematoma With Delayed Symptomatic Pleural Effusion: a Case Report." Surgical Case Reports, vol. 5, no. 1, 2019, p. 133.
Shimomura M, Ishihara S, Iwasaki M, et al. Successful thoracoscopic evacuation of an extrapleural hematoma with delayed symptomatic pleural effusion: a case report. Surg Case Rep. 2019;5(1):133.
Shimomura, M., Ishihara, S., Iwasaki, M., & Inoue, M. (2019). Successful thoracoscopic evacuation of an extrapleural hematoma with delayed symptomatic pleural effusion: a case report. Surgical Case Reports, 5(1), p. 133. doi:10.1186/s40792-019-0691-9.
Shimomura M, et al. Successful Thoracoscopic Evacuation of an Extrapleural Hematoma With Delayed Symptomatic Pleural Effusion: a Case Report. Surg Case Rep. 2019 Aug 14;5(1):133. PubMed PMID: 31414255.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Successful thoracoscopic evacuation of an extrapleural hematoma with delayed symptomatic pleural effusion: a case report. AU - Shimomura,Masanori, AU - Ishihara,Shunta, AU - Iwasaki,Masashi, AU - Inoue,Masayoshi, Y1 - 2019/08/14/ PY - 2019/04/11/received PY - 2019/08/07/accepted PY - 2019/8/16/entrez PY - 2019/8/16/pubmed PY - 2019/8/16/medline KW - Blunt KW - Chest wall KW - Pleura KW - Trauma SP - 133 EP - 133 JF - Surgical case reports JO - Surg Case Rep VL - 5 IS - 1 N2 - BACKGROUND: Traumatic extrapleural hematoma is a rare condition and is usually managed conservatively until spontaneous resolution unless active bleeding or expansion is found. CASE PRESENTATION: An 80-year-old man taking an anticoagulant medication was referred to our hospital after accidentally falling in a street ditch while riding a bike. Chest X-ray and computed tomography (CT) scan showed multiple fractures on ribs 7-9, hemothorax, and extrapleural hematoma in the posterior chest wall. Though the patient's hemothorax was improved by chest tube drainage, the extrapleural hematoma still remained. He was transferred to another hospital for rehabilitation, but he was readmitted to our hospital because of dyspnea with accumulation of left pleural effusion, including a subpopulation of neutrophils, but without bacterial infection. We performed thoracoscopic evacuation of the hematoma on day 57 after the initial blunt chest trauma. The patient has had no recurrence of pleuritis for 6 months after surgery. CONCLUSION: Since posttraumatic extrapleural hematoma may result in delayed secondary intractable pleural effusion causing dyspnea, careful observation is necessary when considering indications of surgical intervention. SN - 2198-7793 UR - https://www.unboundmedicine.com/medline/citation/31414255/Successful_thoracoscopic_evacuation_of_an_extrapleural_hematoma_with_delayed_symptomatic_pleural_effusion:_a_case_report L2 - https://dx.doi.org/10.1186/s40792-019-0691-9 DB - PRIME DP - Unbound Medicine ER -