A 72-year-old woman was transferred to our emergency oom after sustaining a motorcycle collision. She was a passenger and fell down to the ground. She was initially managed in a local clinic where she received tube thoracos-tomy for right side hemothorax. On chest tube insertion, 800 ml of fresh blood was drained out. She was transferred to our emergency room because of absence of thoracic surgeon at the referring clinic. She was alert, dyspneic, and hypotensive on arrival. Physical examination revealed chest wall contusion with hematoma formation, decreased breath sound over right lung field, large amount of fresh blood through tube thoracostomy (500 ml in 30 minutes), and back pain. Initial resuscitation with crystalloid infusion and blood product transfusion was given. An emergent chest computed tomography (CT) disclosed bilateral hemothorax, with right side more than left side (Fig. 1) and burst fracture of Til spine and compression fracture of T12 spine (Fig. 2). Because of massive hemothorax (>1300 ml in <2 hours with profuse bleeding), she was rushed to the operating room without further studies. Through a standard posterolateral thoracot-omy incision, the right sixth intercostal was used to access the thoracic cavity.
展开▼
