Chest injuries can cause a hemothorax, which is accumulation of blood in the chest cavity. Blood in your chest cavity results from injury to:
- Blood vessels that run alongside each rib
- The heart
- Major blood vessels around the heart.
Your physician will diagnose your condition using a chest x-ray, an ultrasound or a CT scan.
Treatment of Hemothorax
We may recommend observation if you have a clinically insignificant amount of blood.
If your hemothorax is large or causing symptoms, your doctor will need to remove the collected blood. He or she can do this in different ways.
A chest tube treatement involves having your doctor make a small hole between your ribs. He or she will put a chest tube through the hole and into the collection of blood or fluid in the chest. The chest tube will stay in your chest for a few days, or more, until the drainage from the tube slows down. Before we remove your chest tube, we make sure the blood is gone using an x-ray and physical examination. You will need to stay in the hospital while this tube is in your chest.
Surgery for Hemothorax
Sometimes you need surgery to remove the blood from the chest cavity. We do this if the blood was not drained with the chest tube alone. If the blood has been in the chest for several days, it can become very thick. To remove it, your doctor needs to be more invasive.
We call the surgery to remove blood from your chest a thoracoscopy or VATS (Video-assisted Thoracic Surgery). You will be under under general anesthesia for your procedure. Your doctor makes 2 or 3 small cuts between the ribs in your chest. He or she will put long, thin tools in these openings and into the space where the air collected. One of the tools has a camera on the end, which sends pictures to a TV screen. The doctor can look at the image on the screen to do your surgery.
If your doctor feels we cannot clear your hemothorax using minimally invasive surgery, he or she will recommend a different service. This may be a thoracotomy, or open chest surgery.
After surgery you will have one or more chest tubes placed to continue draining the fluid and blood from your chest. You will need to stay in the hospital for 3-7 days, or more, as you recover. Your chest tube remains in your chest, and is removed only after we confirm your healing as expected. Confirmation of healing involves an examination by your doctor and a chest x-ray.