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Spontan hemopnömotorakslı hastaların değerlendirilmesi

Year 2017, Volume: 30 Issue: 3, 177 - 180, 22.10.2017
https://doi.org/10.5472/marumj.370858

Abstract

Amaç: Spontan hemopnömotoraks (SHP), nadir görülen bir

hastalıktır. Zamanında tanınmaz ve tedavi edilmezse hayatı tehdit

edebilir. Bu çalışmanın amacı SHP’ lı hastaların tedavisinde

kurumumuzun deneyimlerini paylaşmaktır.

Hastalar ve Yöntemler: Temmuz 2005-Mayıs 2017 yılları

arasında 610 adet spontan pnömotoraks hastası kliniğimize

başvurdu. Hastaların yaşı, cinsiyeti, etkilenen taraf, drenaj

miktarı, klinik bulguları ve tedavi sonuçları retrospektif olarak

değerlendirildi.

Bulgular: Tüm hastaların ön-arka akciğer (PA Akc) grafisi,

bilgisayarlı toraks tomografisi (BT), tam kan, biyokimya ve

koagulasyon testleri değerlendirildi. Tüm hastalara kapalı su altı

drenajı uygulandı. Altıyüz on hastadan 7 (%1,14)’sinde SHP tesbit

edildi. Toraks drenaj takibi sonrası 7 hasta operasyona alındı.

Üç hastaya video yardımlı torakoskopik cerrahi (VYTC), diğer

hastalara torakotomi yapıldı. Postoperatif komplikasyon olmadı.

Sonuç: Travma hikâyesi olmadan ani başlayan göğüs ağrısı ve

nefes darlığı olan hastalarda, radyografide pnömotoraksla beraber

sıvı seviyesi var ise SHP düşünülmelidir. İlk tedavi yaklaşımı

tüp torakostomi olmalıdır. Sonrasında, hasta yakın klinik ve

hemodinamik kontrol altında tutulmalı ve eğer kanama devam

ederse öncelikli olarak VATS veya acil torakotomi uygulanmalıdır.

Böylece erken tanı ve uygun cerrahi yaklaşımla gelişebilecek

ölümcül komplikasyonlar önlenebilir.

References

  • Homma T, Sugiyama S, Kotoh K, Doki Y, Tsuda M, Misaki T. Early surgery for treatment of spontaneous hemopneumothorax. Scand J Surg 2009; 98: 160-3. doi: 10.1177/145749690909800306
  • Tatebe S, Kanazawa H, Yamazaki Y, Aoki E, Sakurai Y. Spontaneous hemo-pneumothorax. Ann Thorac Surg 1996;62:1011-5. doi: 10.1016/0003-4975(96)00445-6
  • Calvin SH NG, Anthony PC Y. Spontaneous hemopneumothorax. Curr Opin Pulm Med 2006;12:273-7.
  • Hsu CC, Wu YL, Lın HJ, et al. Indicators of haemothorax in patients with spontaneous pneumothorax. Emerg Med J 2005; 22: 415-7. doi: 10.1136/emj.2003.013441
  • Abyholm F, Storen G. Spontaneous hemopneumothorax. Thorax 1973; 28:376-8.
  • Kakamad F, Othman S. Primary spontaneous hemopneumothorax: A meta-analysis study. Edorium J Cardiothorac Vasc Surg 2016;2:6-11. doi: 10.5348/C04- 2016-10-OA-2
  • Tulay CM, Aygün M. Emergency surgery for spontaneous hemopneumothorax. J Coll Physicians Surg Pak 2014;24:435- 47. doi: 06.2014/JCPSP.435437
  • Tay CK, Yee YC, Asmat A. Spontaneous hemopneumothorax: Our experience with surgical management. Asian Cardiovasc Thorac Ann 2015;23:308-10. doi: 10.1177/0218492314561502
  • Haciibrahimoglu G, Cansever L, Kocaturk C, Aydogmus U, Bedirhan MA. Spontaneous Hemopneumothorax: Is conservative treatment enough? Thorac Cardiovasc Surg 2005; 53: 240-2. doi: 10.1055/s-2005-837647
  • Çobanoğlu U, Sayır F, Sertoğullarından B, Mergan, Aydın İ. Spontaneous Hemopneumothorax: Analysis of 8 cases. J Clin Anal Med 2012;3:59-62. doi: 10.4328/JCAM.561
  • Ng CSH, Lee TW, Wan S, Yim APC. Video assisted thoracic surgery in the management of spontaneous pneumothorax: the current status. Postgrad Med J 2006;82:179-85. doi: 10.1136/pgmj.2005.038398
  • Kim ES, Kang JY, Pyo CH, Jeon EY, Lee WB. 12 year experience of spontaneous hemopneumothorax. Ann Thorac Cardiovasc Surg 2008:14:149-53.
  • Miyazawa M, Fujita T, Misawa R, et al. Thoracoscopic treatment for spontaneous hemo-pneumothorax. Surg Endosc 2002;16:1106. doi: 10.1007/s00464-001-4182-1
  • Patrini D, Panagiotopoulos N, Pararajasingham J, Gvinianidze L, Iqbal Y, Lawrence DR. Etiology and management of spontaneous hemothorax. J Thorac Dis 2015:7:520-6. doi: 10.3978/j.issn.2072-1439.2014.12.50

Evaluation of patients diagnosed with spontaneous hemopneumothorax

Year 2017, Volume: 30 Issue: 3, 177 - 180, 22.10.2017
https://doi.org/10.5472/marumj.370858

Abstract

Objective: Spontaneous hemopneumothorax (SHP) may threaten

life unless timely diagnosed and appropriately treated. The aim

of this study was to review our institutional experience in the

management of patients with SHP.

Patients and Methods: We retrospectively analyzed age, gender,

the affected side, the amount of drainage, clinical findings, and

treatment outcomes of 610 patients with diagnosis of spontaneous

pneumothorax at emergency department. Later, they were admitted

to the Department of Thoracic Surgery, Dicle University Hospital.

Results: Posteroanterior chest radiographs, thoracic computed

tomography (CT) scans, biochemistry and coagulation test results of all

patients were evaluated. All patients underwent closed chest drainage.

Seven (1.14%) of 610 patients were diagnosed with SHP. These patients

underwent operation after thoracic drainage. Three of them were

operated by video-assisted thoracoscopic surgery (VATS) and the others

by thoracotomy. No postoperative complication was observed.

Conclusion: SHP should be considered in patients presenting

with sudden chest pain and dyspnea when there is air-fluid level

in addition to pneumothorax on radiography. The first treatment

approach should be the application of tube thoracostomy. Next

step should include close clinical and hemodynamic control and

be followed primarily by VATS or urgent thoracotomy in case of

continued bleeding. An early diagnosis and appropriate surgical

approach can prevent fatal complications.

References

  • Homma T, Sugiyama S, Kotoh K, Doki Y, Tsuda M, Misaki T. Early surgery for treatment of spontaneous hemopneumothorax. Scand J Surg 2009; 98: 160-3. doi: 10.1177/145749690909800306
  • Tatebe S, Kanazawa H, Yamazaki Y, Aoki E, Sakurai Y. Spontaneous hemo-pneumothorax. Ann Thorac Surg 1996;62:1011-5. doi: 10.1016/0003-4975(96)00445-6
  • Calvin SH NG, Anthony PC Y. Spontaneous hemopneumothorax. Curr Opin Pulm Med 2006;12:273-7.
  • Hsu CC, Wu YL, Lın HJ, et al. Indicators of haemothorax in patients with spontaneous pneumothorax. Emerg Med J 2005; 22: 415-7. doi: 10.1136/emj.2003.013441
  • Abyholm F, Storen G. Spontaneous hemopneumothorax. Thorax 1973; 28:376-8.
  • Kakamad F, Othman S. Primary spontaneous hemopneumothorax: A meta-analysis study. Edorium J Cardiothorac Vasc Surg 2016;2:6-11. doi: 10.5348/C04- 2016-10-OA-2
  • Tulay CM, Aygün M. Emergency surgery for spontaneous hemopneumothorax. J Coll Physicians Surg Pak 2014;24:435- 47. doi: 06.2014/JCPSP.435437
  • Tay CK, Yee YC, Asmat A. Spontaneous hemopneumothorax: Our experience with surgical management. Asian Cardiovasc Thorac Ann 2015;23:308-10. doi: 10.1177/0218492314561502
  • Haciibrahimoglu G, Cansever L, Kocaturk C, Aydogmus U, Bedirhan MA. Spontaneous Hemopneumothorax: Is conservative treatment enough? Thorac Cardiovasc Surg 2005; 53: 240-2. doi: 10.1055/s-2005-837647
  • Çobanoğlu U, Sayır F, Sertoğullarından B, Mergan, Aydın İ. Spontaneous Hemopneumothorax: Analysis of 8 cases. J Clin Anal Med 2012;3:59-62. doi: 10.4328/JCAM.561
  • Ng CSH, Lee TW, Wan S, Yim APC. Video assisted thoracic surgery in the management of spontaneous pneumothorax: the current status. Postgrad Med J 2006;82:179-85. doi: 10.1136/pgmj.2005.038398
  • Kim ES, Kang JY, Pyo CH, Jeon EY, Lee WB. 12 year experience of spontaneous hemopneumothorax. Ann Thorac Cardiovasc Surg 2008:14:149-53.
  • Miyazawa M, Fujita T, Misawa R, et al. Thoracoscopic treatment for spontaneous hemo-pneumothorax. Surg Endosc 2002;16:1106. doi: 10.1007/s00464-001-4182-1
  • Patrini D, Panagiotopoulos N, Pararajasingham J, Gvinianidze L, Iqbal Y, Lawrence DR. Etiology and management of spontaneous hemothorax. J Thorac Dis 2015:7:520-6. doi: 10.3978/j.issn.2072-1439.2014.12.50
There are 14 citations in total.

Details

Subjects Clinical Sciences
Journal Section Articles
Authors

Menduh Oruç This is me

Serdar Monis This is me

Atalay Şahin This is me

Ahmet Erbey This is me

Fatih Meterolu This is me

Serdar Onat This is me

Publication Date October 22, 2017
Published in Issue Year 2017 Volume: 30 Issue: 3

Cite

APA Oruç, M., Monis, S., Şahin, A., Erbey, A., et al. (2017). Evaluation of patients diagnosed with spontaneous hemopneumothorax. Marmara Medical Journal, 30(3), 177-180. https://doi.org/10.5472/marumj.370858
AMA Oruç M, Monis S, Şahin A, Erbey A, Meterolu F, Onat S. Evaluation of patients diagnosed with spontaneous hemopneumothorax. Marmara Med J. October 2017;30(3):177-180. doi:10.5472/marumj.370858
Chicago Oruç, Menduh, Serdar Monis, Atalay Şahin, Ahmet Erbey, Fatih Meterolu, and Serdar Onat. “Evaluation of Patients Diagnosed With Spontaneous Hemopneumothorax”. Marmara Medical Journal 30, no. 3 (October 2017): 177-80. https://doi.org/10.5472/marumj.370858.
EndNote Oruç M, Monis S, Şahin A, Erbey A, Meterolu F, Onat S (October 1, 2017) Evaluation of patients diagnosed with spontaneous hemopneumothorax. Marmara Medical Journal 30 3 177–180.
IEEE M. Oruç, S. Monis, A. Şahin, A. Erbey, F. Meterolu, and S. Onat, “Evaluation of patients diagnosed with spontaneous hemopneumothorax”, Marmara Med J, vol. 30, no. 3, pp. 177–180, 2017, doi: 10.5472/marumj.370858.
ISNAD Oruç, Menduh et al. “Evaluation of Patients Diagnosed With Spontaneous Hemopneumothorax”. Marmara Medical Journal 30/3 (October 2017), 177-180. https://doi.org/10.5472/marumj.370858.
JAMA Oruç M, Monis S, Şahin A, Erbey A, Meterolu F, Onat S. Evaluation of patients diagnosed with spontaneous hemopneumothorax. Marmara Med J. 2017;30:177–180.
MLA Oruç, Menduh et al. “Evaluation of Patients Diagnosed With Spontaneous Hemopneumothorax”. Marmara Medical Journal, vol. 30, no. 3, 2017, pp. 177-80, doi:10.5472/marumj.370858.
Vancouver Oruç M, Monis S, Şahin A, Erbey A, Meterolu F, Onat S. Evaluation of patients diagnosed with spontaneous hemopneumothorax. Marmara Med J. 2017;30(3):177-80.