Unveiling Different Ways for Management of Delayed Traumatic Hemothorax

Background: Delayed traumatic hemothorax is a uncom-mon sequence of blunt thoracic trauma. It occurs in 12% of blunt thoracic trauma. It is commonly associated with rib fracture. Early detection of delayed hemothorax is important to prevent complication as empyema and fibrosis. There are different modalities used in management: Intercostal drain, pigtail catheter, video-assisted thoracoscopic surgery and ex-ploratory thoracotomy. Aim of Study: The aim of this study was to evaluate the dif-ferent ways of management of delayed traumatic hemothorax and their outcome. Patients and Methods: This prospective study was con-ducted at our tertiary center hospital over one year period (June 2023 – May 2024), for patients diagnosed with delayed traumatic hemothorax. Collected data included: Age, mode of trauma, relapsed time between trauma and detection of hemo-thorax, associated thoracic trauma and different ways of man-agement. Results: A Total of 20 patients were included, with mean age of 37.05±17.05 years. Thirteen patients had RTA, four patients after FFH and three patients after falling down.Re-lapsed time between trauma and detection of hemothorax was 5.15±6.55 days. Eleven of them had rib fractures, five patients had lung contusion, and four patients had rib fracture and lung contusion. Sixteen patients were successfully managed by in-tercostal drainage (ICD), one was managed initially by ICD then by thoracotomy, one patient was initially managed by ICD then finally managed by video-assisted thoracoscopic sur-gery (VATS), another one was successfully managed by pigtail and 1 case was explores at first by VATS then converted to open thoracotomy. Conclusion: Patients with blunt thoracic trauma should be followed-up clinically andby chest X-ray during a period between 1-30 days after trauma especially in old-aged patients and in victims of rib fractures. The earlier the intervention, the better results are obtained, and fewer complications oc-cur. Video-assisted thoracoscopic surgery (VATS) is consid-ered one of the best modalities in managing delayed traumatic hemothorax.