Hemothorax Total

**Hemothorax** (English haemothorax; Greek háima - blood and thorax - chest; sinus - anemia) is the accumulation of blood in the pleural cavity and interlobular fissures. The disease usually develops after an open wound to the chest, penetrating through the inspiratory muscles of the neck, including the internal mammary artery and bronchus. The hematoma is located mainly in the anterior pleura due to damage to the vessels of the bronchial artery. It is also possible that blood may accumulate between the layers of the pleura. Sometimes, in addition to hemosinus, transudate accumulates in the pleural cavity - hemopleuritis occurs.

One of the most dangerous complications of hemothorax is the separation of the edges of the wound, which is accompanied by increased bleeding and infection; infection can occur when not only the external skin is wounded, but also internal tissues in the pleural cavity when a purulent accumulation of blood is formed from the very beginning. Thus, hemothorax without bleeding is characterized by a low-symptomatic course, a slight displacement of the mediastinum and a blurred auscultatory picture of a dull or tympanic sound over the entire pulmonary area when straining. Covering the defect by the pleura is accompanied by muscle tension on the affected side, a slightly elevated position of the ribs, widening of the intercostal spaces, displacement of the mediastinum to the opposite side, and a decrease in respiratory sounds. Purulent hemothorax is characterized by the addition of fever, chills, leukocytosis with a neutrophilic shift to the left. X-ray in these cases reveals a homogeneous shadow of the compaction without any defects. Based on X-ray data and laboratory tests, antibiotics are administered under pressure; in more severe cases, lung resection is indicated with parallel surgical drainage of the pleural area to remove tissue debris and constant irrigation of the cavity with antibiotics. Unfortunately, the negative effect of total hemothorax is a very high mortality rate against the background of the development of sepsis as a result of blood