SURGICAL TACTICS FOR COAGULATED HEMOTHORAX

Abstract

We analyzed 78 cases of traumatic coagulated hemothorax (CH occurred in 25 (32.05%) patients as a result of penetrating chest injuries and in 53 (67.95%) as a result of closed chest trauma). On the first day after the injury, 28 (35.90%) victims were admitted, up to 7 days - 23 (29.49%), up to two weeks - 12 (15.38%), up to a month - 10 (12.82%) and later - 5 victims (6.41%). All patients underwent X-ray examinations. At the same time, in 36 (46.15%) patients a horizontal fluid level was determined in the pleural cavity, in 25 (32.05%) patients the presence of air above the fluid level was determined. However, in 17 (21.79%) patients only darkening was detected in the lower floor of the hemithorax. During late visits, MSCT of the chest was used in 15 patients. The following treatment methods for HS were used: conservative in 7 (8.97%) patients; through repeated punctures of the pleural cavity - in 12 (15.39%); drainage of the pleural cavity with the introduction of enzymes (streptase) – in 16 (20.51%); video thoracoscopic sanitation of the pleural cavity - 38 (48.72%); thoracotomy with lung decortication and pleurectomy – in 5 (6.41%). Videothoracoscopic sanitation of the pleural cavity is the most rational and minimally invasive surgical tactic for TSG.