Aamir Bilal, Muhammad Salim, Muhammad Muslim, Muhammad Muqeetullah.
Thoracotomy evacuation of retained posttraumatic hemothorax
J Med Sci Jul 2005;13(2):93-5.
Department of Cardiothoracic Surgery, Lady Reading Hospital, Peshawar

Background: Inadequately drained post-traumatic hemothroax with tube thoracostomy can lead to the complications of fibrothorax/entrapped lung or empyema. The study was designed in our set up to determine the role of surgical intervention for clotted hemothorax and evaluate the outcome of early thoracotomy. Research Methodology: An observational descriptive study was conducted in the Department of Cardiothoracic Surgery, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar from January 2003 to June 2004. The records of all trauma patients undergoing surgical intervention for retained hemothoraces over the 18-month period January 2003 to June 2004 were reviewed. Results: The study included 46 patients. All sustained penetrating injuries, 40 (85%) with stab and 6 (15%) with gunshot wounds. Twenty-two, 17 and 7 patients each had one, two and three attempts at drainage with tube thoracostomy, respectively. In 37 patients (80%), retained infected / uninfected pleural fluid was successfully evacuated though thoracotomy. Dense adhesions were present in all of these patients. The mean time interval between injury and thoracotomy was 14.5 days (range 11-24 days). The mean volume of pleural fluid evacuated was 650mL. The median postoperative stay was 5 days. Conclusion: Early surgery is an accurate, safe and reliable therapy for retained posttraumatic retained hemothorax to prevent later complication of empyema and fibrothorax.

Category: Surgery
Keywords: Thoracotomy. Hemothorax. Trauma.

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