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Hemothorax

MedGen UID:
5510
Concept ID:
C0019123
Pathologic Function
Synonyms: Pleural Hemorrhage; Pleural hemorrhage
SNOMED CT: Hemothorax (31892009); Pleural hemorrhage (31892009)
 
HPO: HP:0012151

Definition

The presence of blood in the pleural space. [from HPO]

Conditions with this feature

Ehlers-Danlos syndrome, type 4
MedGen UID:
82790
Concept ID:
C0268338
Disease or Syndrome
Vascular Ehlers-Danlos syndrome (vEDS) is characterized by arterial, intestinal, and/or uterine fragility; thin, translucent skin; easy bruising; characteristic facial appearance (thin vermilion of the lips, micrognathia, narrow nose, prominent eyes); and an aged appearance to the extremities, particularly the hands. Vascular dissection or rupture, gastrointestinal perforation, or organ rupture are the presenting signs in most adults with vEDS. Arterial rupture may be preceded by aneurysm, arteriovenous fistulae, or dissection but also may occur spontaneously. The majority (60%) of individuals with vEDS who are diagnosed before age 18 years are identified because of a positive family history. Neonates may present with clubfoot, hip dislocation, limb deficiency, and/or amniotic bands. Approximately half of children tested for vEDS in the absence of a positive family history present with a major complication at an average age of 11 years. Four minor diagnostic features – distal joint hypermobility, easy bruising, thin skin, and clubfeet – are most often present in those children ascertained without a major complication.
Alpha-2-plasmin inhibitor deficiency
MedGen UID:
414178
Concept ID:
C2752081
Disease or Syndrome
Alpha-2-plasmin inhibitor deficiency is a rare autosomal recessive hemorrhagic diathesis. Most bleeds are severe, appear during childhood, and, in a few cases, umbilical bleeding is the first manifestation. Some homozygous patients present only moderate bleeding (Favier et al., 2001).
Telangiectasia, hereditary hemorrhagic, type 1
MedGen UID:
1643786
Concept ID:
C4551861
Disease or Syndrome
Hereditary hemorrhagic telangiectasia (HHT) is characterized by the presence of multiple arteriovenous malformations (AVMs) that lack intervening capillaries and result in direct connections between arteries and veins. The most common clinical manifestation is spontaneous and recurrent nosebleeds (epistaxis) beginning on average at age 12 years. Telangiectases (small AVMs) are characteristically found on the lips, tongue, buccal and gastrointestinal (GI) mucosa, face, and fingers. The appearance of telangiectases is generally later than epistaxis but may be during childhood. Large AVMs occur most often in the lungs, liver, or brain; complications from bleeding or shunting may be sudden and catastrophic. A minority of individuals with HHT have GI bleeding, which is rarely seen before age 50 years.

Professional guidelines

PubMed

Nezhat C, Lindheim SR, Backhus L, Vu M, Vang N, Nezhat A, Nezhat C
JSLS 2019 Jul-Sep;23(3) doi: 10.4293/JSLS.2019.00029. PMID: 31427853Free PMC Article
Villena Garrido V, Cases Viedma E, Fernández Villar A, de Pablo Gafas A, Pérez Rodríguez E, Porcel Pérez JM, Rodríguez Panadero F, Ruiz Martínez C, Salvatierra Velázquez A, Valdés Cuadrado L
Arch Bronconeumol 2014 Jun;50(6):235-49. Epub 2014 Mar 31 doi: 10.1016/j.arbres.2014.01.016. PMID: 24698396
Broderick SR
Thorac Surg Clin 2013 Feb;23(1):89-96, vi-vii. Epub 2012 Nov 3 doi: 10.1016/j.thorsurg.2012.10.003. PMID: 23206720

Recent clinical studies

Etiology

Patel NJ, Dultz L, Ladhani HA, Cullinane DC, Klein E, McNickle AG, Bugaev N, Fraser DR, Kartiko S, Dodgion C, Pappas PA, Kim D, Cantrell S, Como JJ, Kasotakis G
Am J Surg 2021 May;221(5):873-884. Epub 2020 Nov 17 doi: 10.1016/j.amjsurg.2020.11.032. PMID: 33487403
Dogrul BN, Kiliccalan I, Asci ES, Peker SC
Chin J Traumatol 2020 Jun;23(3):125-138. Epub 2020 Apr 20 doi: 10.1016/j.cjtee.2020.04.003. PMID: 32417043Free PMC Article
Sum SK, Peng YC, Yin SY, Huang PF, Wang YC, Chen TP, Tung HH, Yeh CH
Trials 2019 Dec 30;20(1):797. doi: 10.1186/s13063-019-3943-x. PMID: 31888765Free PMC Article
Cantey EP, Walter JM, Corbridge T, Barsuk JH
Curr Opin Pulm Med 2016 Jul;22(4):378-85. doi: 10.1097/MCP.0000000000000285. PMID: 27093476Free PMC Article
Yamamoto L, Schroeder C, Morley D, Beliveau C
Crit Care Nurs Q 2005 Jan-Mar;28(1):22-40. doi: 10.1097/00002727-200501000-00004. PMID: 15732422

Diagnosis

Patel NJ, Dultz L, Ladhani HA, Cullinane DC, Klein E, McNickle AG, Bugaev N, Fraser DR, Kartiko S, Dodgion C, Pappas PA, Kim D, Cantrell S, Como JJ, Kasotakis G
Am J Surg 2021 May;221(5):873-884. Epub 2020 Nov 17 doi: 10.1016/j.amjsurg.2020.11.032. PMID: 33487403
Nezhat C, Lindheim SR, Backhus L, Vu M, Vang N, Nezhat A, Nezhat C
JSLS 2019 Jul-Sep;23(3) doi: 10.4293/JSLS.2019.00029. PMID: 31427853Free PMC Article
Feden JP
Clin Sports Med 2013 Apr;32(2):255-65. Epub 2013 Jan 29 doi: 10.1016/j.csm.2012.12.003. PMID: 23522507
Broderick SR
Thorac Surg Clin 2013 Feb;23(1):89-96, vi-vii. Epub 2012 Nov 3 doi: 10.1016/j.thorsurg.2012.10.003. PMID: 23206720
Yamamoto L, Schroeder C, Morley D, Beliveau C
Crit Care Nurs Q 2005 Jan-Mar;28(1):22-40. doi: 10.1097/00002727-200501000-00004. PMID: 15732422

Therapy

Carrié C, Rieu B, Benard A, Trin K, Petit L, Massri A, Jurcison I, Rousseau G, Tran Van D, Reynaud Salard M, Bourenne J, Levrat A, Muller L, Marie D, Dahyot-Fizelier C, Pottecher J, David JS, Godet T, Biais M
Crit Care 2023 Apr 26;27(1):163. doi: 10.1186/s13054-023-04429-2. PMID: 37101272Free PMC Article
Kulvatunyou N, Bauman ZM, Zein Edine SB, de Moya M, Krause C, Mukherjee K, Gries L, Tang AL, Joseph B, Rhee P
J Trauma Acute Care Surg 2021 Nov 1;91(5):809-813. doi: 10.1097/TA.0000000000003180. PMID: 33843831
Bauman ZM, Kulvatunyou N, Joseph B, Gries L, O'Keeffe T, Tang AL, Rhee P
World J Surg 2021 Mar;45(3):880-886. Epub 2021 Jan 7 doi: 10.1007/s00268-020-05852-0. PMID: 33415448Free PMC Article
Sum SK, Peng YC, Yin SY, Huang PF, Wang YC, Chen TP, Tung HH, Yeh CH
Trials 2019 Dec 30;20(1):797. doi: 10.1186/s13063-019-3943-x. PMID: 31888765Free PMC Article
Cantey EP, Walter JM, Corbridge T, Barsuk JH
Curr Opin Pulm Med 2016 Jul;22(4):378-85. doi: 10.1097/MCP.0000000000000285. PMID: 27093476Free PMC Article

Prognosis

Mergan İliklerden D, Çobanoğlu U, Sayır F, İliklerden ÜH
Ulus Travma Acil Cerrahi Derg 2022 Mar;28(3):328-335. doi: 10.14744/tjtes.2020.07242. PMID: 35485551Free PMC Article
Wang X, Lu Z, Luo Y, Cai J, Wei J, Liu A, Zeng Z
Medicine (Baltimore) 2022 Feb 11;101(6):e28785. doi: 10.1097/MD.0000000000028785. PMID: 35147108Free PMC Article
Holsen MR, Tameron AM, Evans DC, Thompson M
Ann Pharmacother 2019 Oct;53(10):1060-1066. Epub 2019 Apr 21 doi: 10.1177/1060028019846122. PMID: 31007039
Cantey EP, Walter JM, Corbridge T, Barsuk JH
Curr Opin Pulm Med 2016 Jul;22(4):378-85. doi: 10.1097/MCP.0000000000000285. PMID: 27093476Free PMC Article
Yamamoto L, Schroeder C, Morley D, Beliveau C
Crit Care Nurs Q 2005 Jan-Mar;28(1):22-40. doi: 10.1097/00002727-200501000-00004. PMID: 15732422

Clinical prediction guides

Fitzpatrick ER
Crit Care Nurs Clin North Am 2023 Jun;35(2):129-144. Epub 2023 Mar 27 doi: 10.1016/j.cnc.2023.02.005. PMID: 37127370
Patel NJ, Dultz L, Ladhani HA, Cullinane DC, Klein E, McNickle AG, Bugaev N, Fraser DR, Kartiko S, Dodgion C, Pappas PA, Kim D, Cantrell S, Como JJ, Kasotakis G
Am J Surg 2021 May;221(5):873-884. Epub 2020 Nov 17 doi: 10.1016/j.amjsurg.2020.11.032. PMID: 33487403
Bauman ZM, Kulvatunyou N, Joseph B, Gries L, O'Keeffe T, Tang AL, Rhee P
World J Surg 2021 Mar;45(3):880-886. Epub 2021 Jan 7 doi: 10.1007/s00268-020-05852-0. PMID: 33415448Free PMC Article
Pieracci FM, Leasia K, Bauman Z, Eriksson EA, Lottenberg L, Majercik S, Powell L, Sarani B, Semon G, Thomas B, Zhao F, Dyke C, Doben AR
J Trauma Acute Care Surg 2020 Feb;88(2):249-257. doi: 10.1097/TA.0000000000002559. PMID: 31804414
Sum SK, Peng YC, Yin SY, Huang PF, Wang YC, Chen TP, Tung HH, Yeh CH
Trials 2019 Dec 30;20(1):797. doi: 10.1186/s13063-019-3943-x. PMID: 31888765Free PMC Article

Recent systematic reviews

Beeton G, Ngatuvai M, Breeding T, Andrade R, Zagales R, Khan A, Santos R, Elkbuli A
Am Surg 2023 Jun;89(6):2743-2754. Epub 2023 Feb 20 doi: 10.1177/00031348231157809. PMID: 36802811
Xiong X, Xiong Y, Liu G
Ann Palliat Med 2021 Nov;10(11):11721-11732. doi: 10.21037/apm-21-3163. PMID: 34872297
Patel NJ, Dultz L, Ladhani HA, Cullinane DC, Klein E, McNickle AG, Bugaev N, Fraser DR, Kartiko S, Dodgion C, Pappas PA, Kim D, Cantrell S, Como JJ, Kasotakis G
Am J Surg 2021 May;221(5):873-884. Epub 2020 Nov 17 doi: 10.1016/j.amjsurg.2020.11.032. PMID: 33487403
Hebra A, Kelly RE, Ferro MM, Yüksel M, Campos JRM, Nuss D
J Pediatr Surg 2018 Apr;53(4):728-732. Epub 2017 Jul 31 doi: 10.1016/j.jpedsurg.2017.07.020. PMID: 28822540
Janik M, Straka L, Krajcovic J, Hejna P, Hamzik J, Novomesky F
Forensic Sci Int 2014 Mar;236:22-9. Epub 2013 Dec 25 doi: 10.1016/j.forsciint.2013.12.013. PMID: 24529771

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