(See also Introduction to Chest Injuries.)
Hemothorax is an accumulation of blood between the lung and the chest wall.
Hemothorax can result from any injury—blunt or penetrating―that cuts or tears a lung or an artery or vein in the chest. Blood may then accumulate in the pleural space―between the two layers of tissue that cover the lungs. A large amount of blood may press on the lungs and make breathing difficult. When air as well as blood enters this space, the disorder is called hemopneumothorax. Occasionally, hemothorax is caused by chest surgery or another disorder, such as tuberculosis or lung cancer.
Hemothorax is not painful, but the injury that caused it usually is. The severity of other symptoms depends in part on the amount of blood in the pleural space. If the amount of blood is small, people usually have no other symptoms. People with a large amount of blood may feel short of breath, and breathing may be shallow and rapid. A massive amount of blood may cause blood pressure to become dangerously low (shock). The skin may be cool, sweaty, and bluish.
Doctors give fluids intravenously to increase the amount of fluid in the bloodstream and thus increase blood pressure. If a large amount of blood has been lost, a blood transfusion is necessary.
Doctors usually insert a chest tube (thoracostomy) into the chest to remove the blood and to allow the lung to reinflate. The tube may need to remain in place for several days.
If a lot of blood is present or if bleeding continues, surgery (thoracotomy) may be done to stop the bleeding.