Hemopneumothorax

What is hemopneumothorax?

Hemopneumothorax is when you have blood (hemothorax) and air (pneumothorax, or collapsed lung) in your pleural space at the same time, which makes it difficult or impossible for your lung to fully inflate. Your pleural space is a hollow area (cavity) between your lungs and underneath your chest wall.

Hemopneumothorax usually occurs after a sudden physical injury to your chest, like a car accident, a fall from a height or a knife or gunshot wound.

If you have symptoms of hemopneumothorax, seek medical assistance immediately.

Is hemopneumothorax serious?

Yes, hemopneumothorax is serious and requires immediate medical attention. Without treatment, air and blood can put so much pressure on your lungs that they can’t inflate. This can lead to complications, such as:

• Inability to breathe.
• Heart failure.
• Death.

Types of hemopneumothorax

There are two types of hemopneumothorax:

• Traumatic hemopneumothorax. This type usually occurs after a traumatic injury to your chest. In rare cases, another condition may cause traumatic hemopneumothorax, including lung cancer or rheumatoid arthritis.
• Spontaneous hemopneumothorax. This type occurs without any apparent reason.

How common is hemopneumothorax?

Hemopneumothorax is rare.

A few thousand people have pneumothorax each year. Experts estimate that there are about 300,000 cases of hemothorax each year. About 5% of people who have pneumothorax also have hemothorax.

What are the symptoms of hemopneumothorax?

Hemopneumothorax symptoms may include:

• Chest pain.
• Difficulty breathing, especially when trying to take deep breaths.
• Rapid breathing (hyperventilation).
• Shortness of breath (dyspnea).
• Fatigue.
• Rapid heart rate (tachycardia).
• Anxiety.

What causes a hemopneumothorax?

Traumatic hemopneumothorax is the most common type of hemopneumothorax. Causes usually involve chest trauma, such as something hitting or piercing your chest. These may include:

• Sports injuries, usually from sports that have impact risks, like football, hockey, lacrosse, weightlifting, boxing, wrestling or martial arts.
• Automobile accidents.
• Falls.
• Puncture wounds, like from a knife, gunshot or a medical procedure such as a biopsy.

Other causes may include:

• Lung cancer.
• Rheumatoid arthritis.
• Thoracic (chest) surgery, including heart surgery.
• A blood clotting disorder.
• Pleural mesothelioma.

In rare cases, spontaneous hemopneumothorax develops without any obvious cause.

What are the complications of hemopneumothorax?

Hemopneumothorax can cause other complications in your body. These may include:

• Difficulty breathing or inability to breathe on your own (respiratory failure).
• Your heart stops pumping blood (cardiac arrest).
• A lung infection, such as empyema or pneumonia.
• Scarring in your pleural tissue or lung tissue.

It’s also possible for hemopneumothorax to come back (recurrence).

How is hemopneumothorax diagnosed?

A healthcare provider will conduct a physical examination and listen to your lungs with a stethoscope (auscultation). They’ll also order imaging tests to confirm their diagnosis and determine where blood and air are collecting around your lungs.

What tests will be done to diagnose hemopneumothorax?

A healthcare provider may order the following imaging tests:

• Chest X-ray. A chest X-ray can help diagnose an injury or condition around your lungs.
• Computed tomography (CT) scan. A CT scan creates a 3D image of your lungs. It provides greater detail than a chest X-ray.
• Ultrasound. An ultrasound will help show where and how much blood and air are collecting around your lungs.

How is hemopneumothorax treated?

Hemopneumothorax treatment requires removing the blood and air from your pleural space.

Your provider may first need to support your breathing by giving you oxygen therapy. In severe cases, you may need mechanical ventilation. A mechanical ventilator is a medical device that breathes for you when you can’t breathe on your own.

Depending on the severity of your hemopneumothorax, they may insert a thin needle (needle aspiration) or a larger chest tube (thoracostomy) between your ribs to remove blood and air from your pleural space. Once they remove the air and blood, they’ll remove the needle or chest tube.

If blood and air continue to fill your pleural space, a surgeon will make an incision (cut) in your chest to treat your damaged tissue. This procedure is a thoracotomy. You may also need a blood transfusion if you lose a lot of blood.

After treatment, the provider will prescribe antibiotics to help prevent an infection and pain relievers to help reduce discomfort as you heal.

What are the side effects of hemopneumothorax treatment?

Hemopneumothorax treatment risks include:

• Pain.
• Bleeding.
• Lung infection.
• Fluid buildup in your lungs (pulmonary edema).

How soon after treatment will I feel better?

It depends on the cause of your hemopneumothorax and the type of treatment you receive.

You may need to stay in a hospital for a few days after chest tube placement or surgery. Puncture wounds or other chest trauma that causes hemopneumothorax can take weeks or months to heal. A healthcare provider will estimate your recovery according to your situation.

Can hemopneumothorax be prevented?

You can’t prevent some hemopneumothorax causes. But the following tips can help reduce your chances:

• Wear protective padding while playing high-impact sports.
• Always wear a seatbelt while in an automobile.
• Clear your home of clutter that could cause you to trip and fall.
• Use a cane, walker or crutches to increase your stability and prevent falls.
• Use the proper tools or equipment to reach things over your head, such as a step ladder, ladder or grabber tool. Never stand on chairs, stools or tables.
• Stop smoking.
• Avoid or limit activities that involve drastic changes in air pressure, such as flying or scuba diving.

What can I expect if I have hemopneumothorax?

Hemopneumothorax is a serious medical condition that requires immediate medical attention. You may need to stay in a hospital for a few days or longer to ensure you’re healing properly. But with proper diagnosis and prompt treatment, the outlook is good.

There’s a small chance that hemopneumothorax can come back. It’s a good idea to schedule regular appointments with a healthcare provider to monitor your lungs.

When can I go back to work or school?

If you have hemopneumothorax, its cause may prevent you from going to school, work or activities as you recover. A healthcare provider can tell you when you can expect to return.

How do I take care of myself?

Avoid any activities that can damage or put pressure on your lungs, including:

• Smoking.
• Intense workouts, including heavy lifting.
• Contact sports.
• Scuba diving and deep-sea diving.
• Air travel.

When should I see a healthcare provider?

Schedule follow-up appointments with your healthcare provider. They may order imaging tests to make sure you’re healing as expected.

When should I go to the ER?

Go to the nearest emergency room as soon as possible if you have symptoms of hemopneumothorax, especially trouble breathing or intense chest pain.

What questions should I ask a healthcare provider?

• How do you know I have hemopneumothorax?
• How did I get hemopneumothorax?
• How serious is my hemopneumothorax?
• How can I prevent another hemopneumothorax?
• What treatment do you recommend?
• What’s my recovery timeline?
• Will I need extra oxygen?
• Will I need to stay in the hospital?
• How often should I schedule follow-up appointments?

What is the difference between a pneumothorax and a hemopneumothorax?

Pneumothorax is when air enters your pleural space. Hemopneumothorax is a combination of pneumothorax and hemothorax, which is when blood enters your pleural space.

A note from Cleveland Clinic

Hemopneumothorax is a medical condition in which air and blood enter the pleural space around your lungs. It’s a scary condition that requires immediate treatment — causes usually include severe chest trauma. Seek medical care right away if you have symptoms. A healthcare provider can diagnose it, determine where air and blood are accumulating and treat it.