Diagnosis and Treatment of Delayed Hemothorax after Closed Rib Fractures

Objective To explore the causes,diagnosis,treatment and prevention measures of delayed hemothorax after closed rib fractures.Methods The clinical data of 142 patients with delayed hemothorax from January 2001 to December 2011 was retrospectively analyzed.Results All 142 patients were with no hemothorax when admission by chest X-ray or CT examination,but with signs of pleural effusion on 2-29 days after the admission.12 patients underwent the thoracocentesis,130 patients received closed chest drainage.The volume of bloody pleural effusion was more than 500 ml in all cases.The cases underwent the thoracotomy.139 cases were cured and 3 cases were died.Conclusion Closed rib fractures can easily lead to a delayed hemothorax.The regularly check with chest X-ray or CT should early diagnosed the delayed hemothorax.Thoracic drainage with big diameter tube can quickly drain off the pleural effusion;recover the recruitment maneuver,so as to stop bleeding.For the patients with bloody pleural effusion or without recruitment maneuver,the thoracotomy should be performed timely.To raise the awareness of this disease,closely observation of the condition of patients,regularly chest X-ray or CT examination can improve the diagnosis of this disease.