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Treatment strategies for chronic expanding hematomas of the thorax

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Abstract

Purpose

To investigate retrospectively the treatment strategies for chronic expanding hematoma (CEH) of the thorax.

Methods

We reviewed the medical records of six patients treated for CEH of the thorax at our institution between October 1996 and October 2006.

Results

All of the patients had a history of thoracic surgery or tuberculosis with a latent period of 12–55 years before onset. One elderly patient with ischemic heart disease and in poor general health demonstrated a substantial improvement of symptoms after undergoing arterial embolization twice instead of surgery. The remaining five patients underwent either pleuropneumonectomy or a total capsule excision, following which their clinical condition improved remarkably. All six patients were discharged from the hospital. Arterial embolization was performed before surgery, and the amount of intraoperative bleeding ranged from 905 ml to 6 590 ml (average: 2 396 ml).

Conclusion

Chronic expanding hematoma of the thorax may occur after thoracic surgery and a tuberculosis infection; however, considering the risk of massive bleeding during surgery, the decision to perform surgery should be made with extreme care.

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References

  1. Reid JD, Kommareddi S, Lankerani M, Park MC. Chronic expanding hematomas. A clinicopathologic entity. JAMA 1980;244:2441–2442.

    Article  PubMed  CAS  Google Scholar 

  2. Labadie EL, Glover D. Physiopathogenesis of subdural hematomas. Part 1: histological and biochemical comparisons of subcutaneous hematoma in rats with subdural hematoma in man. J Neurosurg 1976;45:382–392.

    Article  PubMed  CAS  Google Scholar 

  3. Hanagiri T, Muranaka H, Hashimoto M, Nishio T, Sakai S, Ono M, et al. Chronic expanding hematoma in the chest. Ann Thorac Surg 1997;64:559–561.

    Article  PubMed  CAS  Google Scholar 

  4. Kiatmura J, Okubo K, Isobe J, Ueno Y. Intrathoracic chronic expnading hematoma 53 years after artificial pneumothorax (as a treatments) for tuberclousis: report of a case. Nihon Kokyuuki Geka Gakkai Zasshi 2005;19:141–144.

    Google Scholar 

  5. Okada D, Koizumi K, Kawamoto M, Haraguchi S, Hirata T, Hirai K, et al. A case of chronic expanding hematoma presenting as a huge mass in the pleural cavity. J Nippon Med Sch 2002;69:282–285.

    Article  Google Scholar 

  6. Roper CL, Cooper JD. Chronic expanding hematoma of the thorax. J Thorac Cardiovasc Surg 2001;122:1046–1048.

    Article  PubMed  CAS  Google Scholar 

  7. Kainuma S, Masai T, Yamauchi T, Takeda K, Iwakura K, Ito H, et al. Chronic expanding intrapericardial hematoma after coronary artery bypass surgery presenting with congestive heart failure. Ann Thorac Cardiovasc Surg 2008;14:52–54.

    PubMed  Google Scholar 

  8. Kunisawa S, Kosaka S, Matsukura T, Nakashima T, Okabayashi T, Miyagawa H, et al. Chronic expanding hematoma in sternum resected 5 years after median sternotomy. Ann Thorac Surg 2008;85:1447–1448.

    Article  PubMed  Google Scholar 

  9. Yeh CC, Hsieh CH, Wang YC, Chung PK, Chen RJ. Concomitant aortic valve and internal mammary artery injuries in blunt chest trauma: report of a case. Surg Today 2009;39:790–794.

    Article  PubMed  Google Scholar 

  10. Kuronuma K, Ootake S, Ikeda K, Taniguchi M, Takezawa C, Takahashi H. Chronic expanding hematoma in the chest. Intern Med 2008;47:1411–1414.

    Article  PubMed  Google Scholar 

  11. Nomori H, Horio H, Kobayashi R, Morinaga S. Expanding intrathoracic hemorrhagic lesion penetrating the thoracic wall: a rare complication of chronic tuberculous pleurisy. Thorac Cardiovasc Surg 1995;43:358–360.

    Article  PubMed  CAS  Google Scholar 

  12. Sato M, Kosaka S, Takahashi T. Life threatening chronic expanding hematoma of the thorax. J Cardiovasc Surg (Torino) 2004;45:511–514.

    CAS  Google Scholar 

  13. Matsuge S, Hosokawa Y, Yamazaki S, Satoh K, Murakami Y, Yamakawa T, et al. Five cases of surgically resected chronic expanding hematoma in the chest. Kyobu Geka 2000;53:768–773.

    PubMed  CAS  Google Scholar 

  14. Kawamura M, Takahashi Y, Sakata Y, Okubo T, Hoshino R, Gouko C. A case of chronic hemorrhagic pyothorax treated by extraperiosteal air plombage method. Jpn J Thorac Cardiovasc Surg 1994;42:1190–1194.

    Google Scholar 

  15. Kobayashi T, Yoshi I, Yamamoto H, Ohtsuka T. Kinchu method used to treat a patient with chronic hemorrhagic pleural effusion. Nihon Kokyuuki Geka Gakkai Zasshi 1990;4:559–563.

    Google Scholar 

  16. Konaka C, Nakajima S, Miyajima K, Furukawa K, Nagase S, Hayashi A, et al. A case of organized empyema treated by modified air-plombage -not extraperiosteal, extrapleual air -plomgabe- Nihon Kokyuuki Geka Gakkai Zasshi 1998;12:39–43.

    Google Scholar 

  17. Fukuhara K, Nakagawa K, Fujiwara K, Shiono H, Ideguchi K, Yasumitsu T. Successful surgery for hemorrrhagic empyema accompanied by an asymptomatic bronchial fistula. Nihon Kokyuuki Geka Gakkai Zasshi 2002;16:554–558.

    Google Scholar 

  18. Suzuki H, Tanaka K, Kanemitsu S, Tanaka J, Tokui T, Kaneda M. Anterior approach for pleuropneumonectomy and thoracoplasty in a patient wit chronic expanding hematoma: a case reprot. Nihon Kokyuuki Geka Gakkai Zasshi 2008;22:111–115.

    Google Scholar 

  19. Tokui T, Kaneda M, Hatanaka K, Tani K, Morimoto T, Sakai T, et al. Anterior approach for pleuropneumonectomy and thoracoplasty with chronic empynema; two successful case reports. Nihon Kokyuuki Geka Gakkai Zasshi 2001;15:705–712.

    Google Scholar 

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Muramatsu, T., Shimamura, M., Furuichi, M. et al. Treatment strategies for chronic expanding hematomas of the thorax. Surg Today 41, 1207–1210 (2011). https://doi.org/10.1007/s00595-010-4462-2

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  • DOI: https://doi.org/10.1007/s00595-010-4462-2

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