Use of Intrapleural Fibrinolytic Therapy in a Trapped Lung following Acute Traumatic Haemothorax

Retained haemothorax is a common sequela of traumatic haemothorax and refers to blood that cannot be drained from the pleural cavity. We report a case of trapped lung secondary to retained haemothorax in a patient who sustained a penetrating chest injury. Initial chest computed tomography (CT) showe...

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Main Authors: Chuan T. Foo, Jurgen Herre
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Pulmonology
Online Access:http://dx.doi.org/10.1155/2021/5592086
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author Chuan T. Foo
Jurgen Herre
author_facet Chuan T. Foo
Jurgen Herre
author_sort Chuan T. Foo
collection DOAJ
description Retained haemothorax is a common sequela of traumatic haemothorax and refers to blood that cannot be drained from the pleural cavity. We report a case of trapped lung secondary to retained haemothorax in a patient who sustained a penetrating chest injury. Initial chest computed tomography (CT) showed a large haemothorax that was managed with an intercostal drain insertion (ICD). Repeat chest CT and thoracic ultrasonography performed after ICD removal showed an organized pleural space resembling haematoma. ICD was reinserted with administration of intrapleural fibrinolytic therapy (IPFT). Subsequent chest CT showed the development of a pleural rind and trapped lung. A second ICD was inserted, and further IPFT were administered together with aggressive negative pressure suction. Haemoglobin remained stable. The patient made a full recovery and imaging performed two weeks later showed minor blunting of the costophrenic angle. This case highlights the feasibility and safety of IPFT in the management of trapped lung associated with traumatic retained haemothorax as an alternative to surgery.
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spelling doaj-art-930b4c35b34748b3b3359865fcd6939e2025-08-20T03:20:36ZengWileyCase Reports in Pulmonology2090-68462090-68542021-01-01202110.1155/2021/55920865592086Use of Intrapleural Fibrinolytic Therapy in a Trapped Lung following Acute Traumatic HaemothoraxChuan T. Foo0Jurgen Herre1Cambridge University Hospitals NHS Foundation Trust, Department of Respiratory Medicine, Cambridge, UKCambridge University Hospitals NHS Foundation Trust, Department of Respiratory Medicine, Cambridge, UKRetained haemothorax is a common sequela of traumatic haemothorax and refers to blood that cannot be drained from the pleural cavity. We report a case of trapped lung secondary to retained haemothorax in a patient who sustained a penetrating chest injury. Initial chest computed tomography (CT) showed a large haemothorax that was managed with an intercostal drain insertion (ICD). Repeat chest CT and thoracic ultrasonography performed after ICD removal showed an organized pleural space resembling haematoma. ICD was reinserted with administration of intrapleural fibrinolytic therapy (IPFT). Subsequent chest CT showed the development of a pleural rind and trapped lung. A second ICD was inserted, and further IPFT were administered together with aggressive negative pressure suction. Haemoglobin remained stable. The patient made a full recovery and imaging performed two weeks later showed minor blunting of the costophrenic angle. This case highlights the feasibility and safety of IPFT in the management of trapped lung associated with traumatic retained haemothorax as an alternative to surgery.http://dx.doi.org/10.1155/2021/5592086
spellingShingle Chuan T. Foo
Jurgen Herre
Use of Intrapleural Fibrinolytic Therapy in a Trapped Lung following Acute Traumatic Haemothorax
Case Reports in Pulmonology
title Use of Intrapleural Fibrinolytic Therapy in a Trapped Lung following Acute Traumatic Haemothorax
title_full Use of Intrapleural Fibrinolytic Therapy in a Trapped Lung following Acute Traumatic Haemothorax
title_fullStr Use of Intrapleural Fibrinolytic Therapy in a Trapped Lung following Acute Traumatic Haemothorax
title_full_unstemmed Use of Intrapleural Fibrinolytic Therapy in a Trapped Lung following Acute Traumatic Haemothorax
title_short Use of Intrapleural Fibrinolytic Therapy in a Trapped Lung following Acute Traumatic Haemothorax
title_sort use of intrapleural fibrinolytic therapy in a trapped lung following acute traumatic haemothorax
url http://dx.doi.org/10.1155/2021/5592086
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