Hematopneumothorax is a pathological phenomenon that occurs after trauma to the thorax or so-called iatrogenic injuries to the lungs. In this case, the affected patients suffer from a mixture of the symptoms of pneumothorax and hematothorax.
What is hematopneumothorax?
Hematopneumothorax results from a variety of traumatic impacts to the thorax. For example, lung injuries or surgical procedures cause some individuals to develop the typical symptoms of hematopneumothorax. Rapid diagnosis of the phenomenon and competent treatment of hematopneumothorax are of immense importance for the patient’s life. If such measures are not taken, life-threatening complications sometimes develop and hematopneumothorax ends in the death of the affected person.
Causes
The causes and processes of the pathogenesis of hematopneumothorax are largely understood, according to numerous medical studies. Hematopneumothorax forms after certain impacts in the thoracic region. Common triggers include trauma to the thorax. Also iatrogenic damages in the area of the lungs lead in many cases to the expression of the phenomenon. Such injuries to the lungs occur in some individuals after surgical procedures or other injuries to the respiratory organ. Sometimes, injuries to the airways, esophagus as well as vessels also lead to the development of hematopneumothorax. The cause is usually found in blood and air entering the gap of the pleura. As a result, the lungs of the diseased person fail. In the course of a so-called tension hematopneumothorax, the intrathoracic pressure in the diseased side of the lung gradually increases. This is due to the action of a particular valve. As a result, the affected half of the lung is squeezed. In addition, the mediastinum may shift. The patient’s breathing is also affected.
Symptoms, complaints, and signs
The symptoms of hematopneumothorax are varied and manifest minimally differently in each person. In some cases, a hematopneumothorax of very minor extent causes no symptoms at all and thus may go undetected. More serious injuries to the thorax are different. People suffering from hematopneumothorax usually experience symptoms such as shortness of breath, a decreased sound when breathing, an increased frequency of air catching, and pain sensations in the corresponding areas. Such symptoms occur mainly when the lungs collapse as a result of the traumatic impact. On medical examination, a decreased palpitation sound is often noticeable, which is sometimes hypersonor. The severity of the abnormality of the knock depends on how severe the hematopneumothorax is in the patient. A specific valve process in some cases exacerbates an existing pneumothorax. In this case, a tension hematopneumothorax may develop. This phenomenon poses an acute threat to human life and requires emergency medical treatment in all cases. Affected individuals suffer acute respiratory distress followed by cyanosis. The mediastinum is pushed out of its usual position. As a result, blood backs up in the veins. The problem becomes visible, for example, in a clear congestion of blood in the veins of the neck. If the blood stasis continues, low blood pressure, shock and tachycardia set in. In the worst case, affected individuals die as a result of tension hematopneumothorax due to cardiovascular arrest. Depending on the individual cause of the hemorrhage, loss of blood is also possible, as a result of which patients go into shock.
Diagnosis and course of the disease
The diagnosis of hematopneumothorax is made by a specialized physician and is based on the results of several examination methods. First, during the patient interview, the sufferer presents his or her symptoms and informs the physician about potentially relevant circumstances of origin. In each case, the physician first examines the area of the thorax for external signs of injury. After that, a so-called auscultation is usually used. Imaging techniques also play a crucial role in the diagnosis of hematopneumothorax.Thus, in the vast majority of cases, the physician performs an X-ray examination, focusing on the lungs. For example, imaging indicates collapse of the lung in an existing hematopneumothorax. In addition, in some patients, fluids accumulate in the thorax and are partially visualized. In addition, ultrasound examinations are usually used. Even a CT scan of the chest is used in some cases. To detect injuries to blood vessels, the physician uses what is known as digital subtraction angiography.
Complications
Hematopneumothorax usually causes discomfort to the lungs. Those affected suffer from shortness of breath, which can not infrequently lead to panic attacks or sweating. Likewise, the shortness of breath can cause a loss of consciousness, which can lead to a fall and further injury. It is not uncommon for pain and discomfort to occur during the breathing itself. The respiratory rate is increased and the patient’s resilience usually decreases enormously. As a result, normal everyday activities and sporting activities are usually no longer possible for the affected person without further ado. Furthermore, blood congestion can develop, resulting in very low blood pressure. This can damage the internal organs and, in the worst case, the heart. The affected person then suffers cardiac arrest and dies. Hematopneumothorax is treated according to its severity. No particular complications occur during the treatment itself. It is possible that the patient’s life expectancy may be reduced if treatment for hematopneumothorax is delayed, resulting in irreversible sequelae.
When should you see a doctor?
A hematopneumothorax can manifest itself with quite different symptoms. These are not always clearly attributable to a serious illness, which is why no medical clarification is usually made at the beginning. However, a visit to the doctor is indicated as soon as serious symptoms such as shortness of breath or altered breathing sounds develop. People who have severe lung pain after an accident or feel generally ill should visit the nearest hospital. This is especially true if the discomfort rapidly increases in intensity. If the person becomes unconscious or has severe shortness of breath, the ambulance service must be called. Accompanying first aid must be given to the affected person. If the symptoms are due to serious injuries in the thoracic region, a doctor should be consulted as soon as possible. In addition to the hematopneumothorax, there may also be internal bleeding or other complications that need to be clarified and treated. The right contact person is the family doctor or a lung specialist. In case of doubt, the medical emergency service or directly the emergency number can be contacted.
Treatment and therapy
Therapeutic measures depend on the severity of the hematopneumothorax. Treatment is often not necessary for a hematopneumothorax of lesser severity. However, the hematopneumothorax should be monitored regularly by a physician in order to react quickly to possible changes. Specific therapeutic measures are required if the lung collapses. Here, the lung is usually relieved by draining the thorax. In the case of a tension hematopneumothorax, immediate relief measures are necessary. Sometimes a puncture is necessary. If the patient loses too much blood, rapid stopping of the hemorrhage is of paramount relevance.
Prevention
Hematopneumothorax should be prevented by avoiding injury and other traumatic procedures to the thorax. However, prevention is not successful in all cases.
Follow-up
Follow-up care for hematopneumothorax depends on the cause and the degree of disease. First, patients should take care to protect the thorax from injury or other harmful influences. After lung treatment in the hospital, the patient should take it easy as much as possible and not take too much strain. It is therefore essential to follow the doctor’s recommendations, especially if there has been more blood loss. In this case, bed rest may even last several weeks until the patient has recovered. The body is then gradually strengthened again by an adapted diet and light exercise therapy.Particularly in the first period after treatment, a light diet is included in the diet to avoid putting too much strain on the lungs. A close-meshed examination by a lung specialist can determine whether recovery is proceeding successfully. If necessary, the physician will detect complications and can take timely action. Patients themselves should be alert to unusual signs or symptoms so that they can raise these issues at follow-up appointments. This will allow the physician to address any potential deterioration early on. In the event of sudden respiratory problems, those affected should not hesitate to go to the nearest hospital.
What you can do yourself
The measures that affected persons can take themselves in the event of a hematopneumothorax depend on the type and severity of the symptoms. In principle, a hematopneumothorax requires treatment in the hospital, as it is a medical emergency. The patient must take it easy during and after treatment and otherwise comply with the physician’s instructions. Especially in case of severe blood loss, the patient should spend several days to weeks in bed. An individual diet as well as moderate exercise supported the body during recovery. The diet should consist of sparing food during the first weeks. Foods and beverages that do not put excessive strain on the lungs are suitable. Patients who have suffered a hematopneumothorax must have regular examinations by a pulmonary specialist after completion of treatment. Close monitoring ensures that recovery proceeds as planned and that a quick response can be made if complications arise. Should breathing difficulties or other unusual symptoms and complaints develop, the responsible physician must be informed in any case or the affected person should be taken to the nearest hospital. This is especially true if the hematopneumothorax occurred in connection with a serious accident.
